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Respiratory Research

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Open Access 01-12-2022 | Bronchial Asthma | Review

Sex differences in adult asthma and COPD therapy: a systematic review

Authors: Paola Rogliani, Francesco Cavalli, Beatrice Ludovica Ritondo, Mario Cazzola, Luigino Calzetta

Published in: Respiratory Research | Issue 1/2022

Abstract

Background

Although asthma is more prevalent in women and the prevalence of COPD is increasing in women, the current international recommendations for the management and prevention of asthma and COPD provide no sex-related indication for the treatment of these diseases. Therefore, we systematically reviewed the evidence across literature on the sex-related effectiveness of asthma and COPD therapy.

Methods

This systematic review has been registered in PROSPERO and performed according to PRISMA-P. The PICO framework was applied for the literature search strategy: "patient problem” included adult patients suffering from asthma or COPD, “Intervention” regarded the pharmacological treatments for asthma or COPD, “Comparison” was vs. baseline, active controls, or placebo, “Outcome” was any difference sex-related in the effectiveness of interventions.

Results

In asthma 44% of the evidence reported that men responded better than women to the therapy, whereas this percentage was 28% in COPD. ICS was generally less effective in women than in men to treat asthma, and consistent evidence suggests that in asthmatic patients ICS/LABA/LAMA combination may be equally effective in both men and women. Due to the inconsistent available evidence, it is not possible to identify specific treatments whose effectiveness is related to sex difference in COPD patients.

Conclusions

There is a strong need of investigating the sex-related impact of asthma and COPD treatments. Pre-specified analyses in men and women should be planned in future trial protocols, a necessary condition that should be requested also by the regulatory agencies to overcome the anachronistic “one-size-fits-all” approach to therapeutics associated with suboptimal outcomes for patients.

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Title: Sex differences in adult asthma and COPD therapy: a systematic review
Authors: Paola Rogliani
Francesco Cavalli
Beatrice Ludovica Ritondo
Mario Cazzola
Luigino Calzetta
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Bronchial Asthma
Tiotropium
Salmeterol
Formoterol
Indacaterol
Aclidinium
Chronic Obstructive Lung Disease
Published in: Respiratory Research / Issue 1/2022
Electronic ISSN: 1465-993X
DOI: https://doi.org/10.1186/s12931-022-02140-4

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