Shan Yuting, Cheung Lee, Zhou Yuqi, Huang Yingbo, Huang R Stephanie
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States.
Front Pharmacol. 2023 May 2;14:1096366. doi: 10.3389/fphar.2023.1096366. eCollection 2023.
Adverse drug reactions (ADRs) are the main safety concerns of clinically used medications. Accumulating evidence has shown that ADRs can affect men and women differently, which suggests sex as a biological predictor in the risk of ADRs. This review aims to summarize the current state of knowledge on sex differences in ADRs with the focus on the commonly used psychotropic, cardiovascular, and analgesic medications, and to aid clinical decision making and future mechanistic investigations on this topic. PubMed search was performed with combinations of the following terms: over 1,800 drugs of interests, sex difference (and its related terms), and side effects (and its related terms), which yielded over 400 unique articles. Articles related to psychotropic, cardiovascular, and analgesic medications were included in the subsequent full-text review. Characteristics and the main findings (male-biased, female-biased, or not sex biased ADRs) of each included article were collected, and the results were summarized by drug class and/or individual drug. Twenty-six articles studying sex differences in ADRs of six psychotropic medications, ten cardiovascular medications, and one analgesic medication were included in this review. The main findings of these articles suggested that more than half of the ADRs being evaluated showed sex difference pattern in occurrence rate. For instance, lithium was found to cause more thyroid dysfunction in women, and amisulpride induced prolactin increase was more pronounced in women than in men. Some serious ADRs were also found to exert sex difference pattern, such as clozapine induced neutropenia was more prevalent in women whereas simvastatin/atorvastatin-related abnormal liver functions were more pronounced in men.
药物不良反应(ADR)是临床用药主要的安全关注点。越来越多的证据表明,ADR对男性和女性的影响存在差异,这表明性别是ADR风险的一个生物学预测指标。本综述旨在总结ADR性别差异方面的现有知识状态,重点关注常用的精神药物、心血管药物和镇痛药物,并有助于该主题的临床决策和未来的机制研究。通过将以下术语组合进行PubMed搜索:1800多种感兴趣的药物、性别差异(及其相关术语)和副作用(及其相关术语),共得到400多篇独特的文章。与精神药物、心血管药物和镇痛药物相关的文章被纳入后续的全文综述。收集每篇纳入文章的特征和主要发现(男性偏向、女性偏向或无性别偏向的ADR),并按药物类别和/或个别药物总结结果。本综述纳入了26篇研究六种精神药物、十种心血管药物和一种镇痛药物ADR性别差异的文章。这些文章的主要发现表明,超过一半被评估的ADR在发生率上呈现出性别差异模式。例如,发现锂在女性中更易导致甲状腺功能障碍,氨磺必利引起的催乳素升高在女性中比在男性中更明显。还发现一些严重的ADR也呈现出性别差异模式,如氯氮平引起的中性粒细胞减少在女性中更普遍,而辛伐他汀/阿托伐他汀相关的肝功能异常在男性中更明显。
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