Gender-specific asthma treatment

Abstract

Because genetic characteristics vary among subjects, the therapeutic effects of a certain drug differ among patients with the same disease. For this reason, special interest has focused on tailored treatments. Although it is well known that sex is genetically determined, little attention has been paid to sex differences in the clinical features and treatment of asthma. Females are more likely to suffer allergic asthma, to have difficulty controlling asthma symptoms, and to show adverse effects to drugs. As asthma symptoms show cyclic changes depending on female hormone levels in many women of child-bearing age, the use of contraceptives may specifically help to treat female patients with asthma such as those with perimenstrual asthma and severe asthma. Generally, testosterone seems to suppress asthma, and dehydroepiandrosterone (DHEA), a less virilizing androgen, may be effective for treating asthma. Evidence exists for a therapeutic and steroid-sparing effect of DHEA. However, further studies on the optimal dose and route of DHEA for each sex are needed. Monitoring of the serum DHEA-S level is necessary for patients with asthma on inhaled steroid treatment, and at minimum, replacement therapy for patients with a low level of DHEA may be helpful for treating their asthma.

Keywords: Asthma; dehydroepiandrosterone; perimenstrual; sex; treatment.

Figure

Sex differences in asthma prevalence. The ratios of female to male patients with asthma and a positive response to skin prick tests using house dust mites (HDM) (redrawn from Wormald6) and in patients who were reported to have asthma in the European Community Respiratory Health Survey (ECRHS) (redrawn from de Marco et al.7), and the number of asthma patients per 100 population for each sex in the General Practice Research Database (redrawn from Osman et al.8).