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Sex-Related Differences in Drugs with Anti-Inflammatory Properties.

André Farkouh1, Christoph Baumgärtel2, Roman Gottardi3

  • 1Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria.

Journal of Clinical Medicine
|April 30, 2021
PubMed
Summary

Women face higher risks from anti-inflammatory drugs due to sex-based differences in drug action. Improved clinical awareness and sex-specific research are crucial for safer medication use and personalized medicine.

Keywords:
COVID-19NSAIDSARS-CoV-2anti-inflammatory druggenderpharmacodynamicspharmacokineticssexsteroid

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Area of Science:

  • Pharmacology
  • Sex-based drug response

Background:

  • Growing evidence highlights significant sex differences in anti-inflammatory drug efficacy and safety.
  • Women exhibit a higher risk of adverse effects from these medications.
  • Current clinical practice often lacks awareness regarding sex-specific drug implications.

Purpose of the Study:

  • To review existing literature on sex differences in the pharmacokinetics and pharmacodynamics of anti-inflammatory drugs.
  • To identify specific differences in drug action, effectiveness, and side effect profiles between sexes.
  • To emphasize the need for improved clinical awareness and sex-differentiated research.

Main Methods:

  • Literature review of studies examining sex differences in anti-inflammatory drug pharmacokinetics and pharmacodynamics.
  • Analysis of data on anti-thrombotic activity, gastro-intestinal, renal, hepatic complications, and hormonal interactions.
  • Evaluation of sex-specific effects of COX-inhibitors, glucocorticosteroids, and TNF-alpha inhibitors.

Main Results:

  • Anti-thrombotic effects of COX-inhibitors are generally stronger in men.
  • Glucocorticosteroids are more effective in men; women show increased sensitivity with high oestradiol levels.
  • TNF-alpha inhibitors have longer half-lives in men, increasing infection risk due to stronger immunosuppression.

Conclusions:

  • Sex significantly influences the effectiveness and safety profiles of anti-inflammatory drugs.
  • Clinical practice requires enhanced awareness of these sex differences for appropriate dosing and monitoring.
  • Systematic sex-differentiated reporting and inclusion of women in clinical trials are essential for advancing personalized medicine.