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女性口服抗凝剂:有何差异?一篇叙述性综述。

Oral Anticoagulants in Women: What's the Difference? A Narrative Review.

作者信息

Faioni Elena Maria, Scimeca Barbara

机构信息

Anticoagulant Clinic, Centro Cardiologico Monzino IRCCS, Milano, Italy.

Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.

出版信息

Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251347938. doi: 10.1177/10760296251347938. Epub 2025 May 29.


DOI:10.1177/10760296251347938
PMID:40440187
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12123104/
Abstract

Gender sensitive medicine refers to the need to individualize epidemiology, diagnosis, knowledge of disease presentation, and therapy based also on sex and gender. An impressive amount of scientific literature deals now with sex and gender differences in disease. Not so much, yet, on individualized therapeutic approaches. Part of the reason lies in how studies that deal with the pharmacology, efficacy and safety of drugs are conducted. Often women are under-represented, and/or no gender specific analysis of outcomes is performed. As a consequence, in many fields of medicine, not as much is known about important and life-saving drug dosage, safety and efficacy in women as in men. Oral anticoagulants are not the exception, even if new regulations are operative regarding inclusion of women in all phases of drug studies. The result is that there are many areas of uncertainty or outright confusion regarding the efficacy and safety of oral anticoagulants in women that need to be addressed.

摘要

性别敏感医学是指需要根据性别对流行病学、诊断、疾病表现知识及治疗进行个体化。目前有大量科学文献探讨疾病中的性别差异。然而,关于个体化治疗方法的研究却不多。部分原因在于药物药理学、疗效和安全性研究的开展方式。女性往往代表性不足,而且/或者未对结果进行性别特异性分析。因此,在医学的许多领域,对于女性重要且能救命的药物剂量、安全性和疗效的了解不如男性。口服抗凝剂也不例外,即使在药物研究各阶段纳入女性方面已有新规定实施。结果是,在口服抗凝剂对女性的疗效和安全性方面存在许多不确定或完全混乱的领域,需要加以解决。

相似文献

[1]
Oral Anticoagulants in Women: What's the Difference? A Narrative Review.

Clin Appl Thromb Hemost. 2025

[2]
Do women bleed more than men when prescribed novel oral anticoagulants for venous thromboembolism? A sex-based meta-analysis.

Thromb Res. 2013-7-26

[3]
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Semin Thromb Hemost. 2015-10

[4]
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Curr Vasc Pharmacol. 2015

[5]
Gender Differences in Efficacy and Safety of Direct Oral Anticoagulants in Atrial Fibrillation: Systematic Review and Network Meta-analysis.

Ann Pharmacother. 2018-4-22

[6]
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Am J Cardiol. 2017-10-15

[7]
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Med Clin North Am. 2015-4-11

[8]
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J Oncol Pharm Pract. 2020-3

[9]
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Ther Innov Regul Sci. 2020-7

[10]
Gender Differences in Atrial Fibrillation: From the Thromboembolic Risk to the Anticoagulant Treatment Response.

Medicina (Kaunas). 2023-1-28

本文引用的文献

[1]
Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation.

N Engl J Med. 2025-1-23

[2]
2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).

Eur Heart J. 2024-9-29

[3]
Gender-Specific Medicine in the European Society of Cardiology Guidelines from 2018 to 2023: Where Are We Going?

J Clin Med. 2024-7-10

[4]
More early bleeds associated with high baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study.

Blood Adv. 2024-9-24

[5]
Temporal Trends of Enrollment by Sex and Race in Major Cardiovascular Randomized Clinical Trials.

CJC Open. 2023-11-2

[6]
Thrombotic events associated with low baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study.

Blood Adv. 2024-4-23

[7]
Real-World Risk of Gastrointestinal Bleeding for Direct Oral Anticoagulants and Warfarin Users: A Distributed Network Analysis Using a Common Data Model.

Gut Liver. 2024-9-15

[8]
Strategies for enhancing the representation of women in clinical trials: an evidence map.

Syst Rev. 2024-1-2

[9]
Gender-Related Factors in Medication Adherence for Metabolic and Cardiovascular Health.

Metabolites. 2023-10-17

[10]
Outcomes of Oral Anticoagulation in Atrial Fibrillation Patients With or Without Comorbid Vascular Disease: Insights From the GARFIELD-AF Registry.

Am J Med. 2023-12

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