<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1130-6343</journal-id>
<journal-title><![CDATA[Farmacia Hospitalaria]]></journal-title>
<abbrev-journal-title><![CDATA[Farm Hosp.]]></abbrev-journal-title>
<issn>1130-6343</issn>
<publisher>
<publisher-name><![CDATA[Grupo Aula Médica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1130-63432020000300007</article-id>
<article-id pub-id-type="doi">10.7399/fh.11394</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Gender bias in therapeutic effort: from research to health care]]></article-title>
<article-title xml:lang="es"><![CDATA[Sesgos de género en el esfuerzo terapéutico: de la investigación a la atención sanitaria]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz-Cantero]]></surname>
<given-names><![CDATA[María-Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blasco-Blasco]]></surname>
<given-names><![CDATA[Mar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chilet-Rosell]]></surname>
<given-names><![CDATA[Elisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peiró]]></surname>
<given-names><![CDATA[Ana M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Alicante Public Health Research Group ]]></institution>
<addr-line><![CDATA[San Vicente del Raspeig Alicante]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Salud Carlos III Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Miguel Hernández Department of Public Health, History of Science and Gynecology ]]></institution>
<addr-line><![CDATA[Elche ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital General de Alicante Instituto de Investigación Sanitaria y Biomédica de Alicante Clinical Pharmacology Unit and Instituto de Investigación Sanitaria y Biomédica]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>44</volume>
<numero>3</numero>
<fpage>109</fpage>
<lpage>113</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1130-63432020000300007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1130-63432020000300007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1130-63432020000300007&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract There are relevant dimensions from a gender perspective related to therapeutic effort. To illustrate and discuss possible gender bias related to medicines, through the consumption analysis in women, the prescription of biological drugs according to sex, the potential gender inequality in adverse drug reactions, and research with clinical trials, as well as the decisions of international institutions in the marketing of medicinal products. There is greater tendency to prescribe pain relievers, regardless of pain, and drugs for low intensity depressive symptoms in women than in men. The opposite occurs in the prescription of statins and adequate doses, and with the greater probability of prescribing anti-tumor necrosis factor in men than in women with ankylosing spondylitis, despite a similar disease burden. Adverse drug reactions are observed more frequently in women than in men, where determinants such as body weight are having little influence on the dosage. It is currently scarcely considered in the prescription that women have differences in the activity of cytochrome CYPP450 enzymes, which can affect the liver's metabolism rate. There are even immunological, genetic and epigenetic effects (due to heredity and uneven gene dosing located in the X and Y chromosomes) that can influence these differences by sex. Finally, through cases of hormonal therapy clinical trials, a drug for women's inhibited sexual desire and a contraceptive for men, gender bias and stereotypes are shown to influence a potential generation of inequalities, especially in adverse drug reactions to the detriment of women. In conclusion, health professionals frequently attribute physical symptoms to women's emotionality, influencing their greater prescription of symptomatic drugs. Whether the same reason influences the lower prescription of therapeutic drugs in women than in men should be analyzed. There are biological determinants to consider due to their influence on a greater pharmacological toxicity in women. Clinical trials should improve according to the gender recommendations by the Food and Drugs Administration.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Existen dimensiones relevantes desde una perspectiva de género relacionadas con el esfuerzo terapéutico. Se pretende ilustrar y traer a debate posibles sesgos de género relacionados con los medicamentos, mediante el análisis del consumo en las mujeres, la prescripción de fármacos biológicos según sexo, la potencial desigualdad de género en las reacciones adversas a los medicamentos y la investigación con ensayos clínicos, así como las decisiones de las instituciones internacionales en la comercialización de medicamentos. Se observa una mayor tendencia a prescribir analgésicos, con independencia del dolor, y fármacos para síntomas depresivos de baja intensidad en mujeres que en hombres. Lo contrario sucede en la prescripción de estatinas y dosis adecuadas, y con la mayor probabilidad de prescripción de antifactor de necrosis tumoral en hombres que en mujeres con espondilitis anquilosante, pese a la similar carga de la enfermedad. Las reacciones adversas a los medicamentos se observan con más frecuencia en mujeres que en hombres, donde determinantes como el peso corporal están influyendo poco en la dosificación. En la actualidad se considera escasamente en la prescripción que las mujeres presentan diferencias en la actividad de las enzimas del citocromo CYPP450, que puede afectar a la velocidad del metabolismo hepático. Incluso hay efectos inmunológicos, genéticos y epigenéticos (por la herencia y la dosificación desigual de los genes ubicados en los cromosomas X e Y) que pueden influir en estas diferencias por sexo. Por último, mediante los casos de ensayos clínicos de la terapia hormonal, un fármaco para el deseo sexual inhibido de las mujeres y un anticonceptivo para hombres, se muestran sesgos y estereotipos de género que influyen en una potencial generación de desigualdades, especialmente en las reacciones adversas a los medicamentos en perjuicio de las mujeres. Concluyendo, los profesionales sanitarios atribuyen con frecuencia a la emocionalidad de las mujeres lo que son síntomas físicos, influyendo en la mayor prescripción de fármacos sintomáticos en ellas. Debe analizarse si la misma razón influye en la menor prescripción de fármacos terapéuticos en mujeres que en hombres. Existen determinantes biológicos a considerar por su influencia en una mayor toxicidad farmacológica en las mujeres. Los ensayos clínicos deben mejorar atendiendo a las recomendaciones de género de la Food and Drug Administration.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Gender]]></kwd>
<kwd lng="en"><![CDATA[Gender bias]]></kwd>
<kwd lng="en"><![CDATA[Clinical trial]]></kwd>
<kwd lng="en"><![CDATA[Adverse effects]]></kwd>
<kwd lng="en"><![CDATA[Statins]]></kwd>
<kwd lng="en"><![CDATA[Infliximab]]></kwd>
<kwd lng="en"><![CDATA[Hormonal therapy]]></kwd>
<kwd lng="en"><![CDATA[Oral hormonal contraceptives]]></kwd>
<kwd lng="en"><![CDATA[Sexual dysfunction]]></kwd>
<kwd lng="es"><![CDATA[Género]]></kwd>
<kwd lng="es"><![CDATA[Sesgos de género]]></kwd>
<kwd lng="es"><![CDATA[Ensayo clínico]]></kwd>
<kwd lng="es"><![CDATA[Efectos adversos]]></kwd>
<kwd lng="es"><![CDATA[Estatinas]]></kwd>
<kwd lng="es"><![CDATA[Infliximab]]></kwd>
<kwd lng="es"><![CDATA[Terapia hormonal]]></kwd>
<kwd lng="es"><![CDATA[Anticonceptivos hormonales orales]]></kwd>
<kwd lng="es"><![CDATA[Disfunción sexual]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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