Have YOU EVER WONDERED …why NSAID use in women calls for extra care?
- NSAIDs are the most widely used pain and anti-inflammatory medications, with higher usage reported in women than men (Farkouh et al., 2021)
- Women are twice as likely to experience adverse effects from NSAID use compared to men (Farkouh et al., 2021)
- Pharmacogenomic testing can identify genetic variants that minimize adverse NSAID responses, enabling more informed and personalized care in women’s health (Theken et al., 2020)
The Challenge
Women face a heightened risk of serious gastrointestinal (GI) and liver complications from nonsteroidal anti-inflammatory drugs, reflecting important sex-based differences in drug response.
- NSAIDs are widely used to manage inflammation, pain, and fever; however, studies have shown that women are disproportionately susceptible to liver injury associated with their use. One study found that women who took NSAIDs were much more likely to develop liver problems, while no strong link was seen in men (Farkouh et al., 2021).
- NSAIDs are also linked to the increased risk of serious GI problems, and women are more than twice as likely as men to experience these complications after repeated use (Neutel et al., 1999). The disparity may come from sex-specific traits, specifically in hormonal regulation, liver metabolism, and immune response (Farkouh et al., 2021).
Benefits & Real-World Applications of PGx
CYP2C9 genetic variants can affect NSAID metabolism, and pharmacogenomic testing helps identify individuals, especially women, who may require adjusted dosing to reduce the risk of adverse effects.
- Pharmacogenomic (PGx) insights offer a path to reducing NSAID-related harm, particularly in women. Differences in the CYP2C9 gene, a major enzyme involved in breaking down many NSAIDs, can significantly affect how these drugs are processed in the body, leading to variability in individual risk for adverse effects (Farkouh et al., 2021; Theken et al., 2020). The genetic variants of the CYP2C9 gene can lead to slower drug clearance, resulting in higher drug levels in the body (Theken et al., 2020). With long-term or repeated NSAID use, it could increase the risk of adverse effects in this patient population.
- For example, Ibuprofen is metabolized primarily by the CYP2C9 enzyme. Individuals with decreased CYP2C9 function may have lower clearance, resulting in elevated drug levels and a heightened risk of adverse effects, particularly gastrointestinal complications such as ulcers or bleeding. Dose adjustment or alternative therapies may be able to reduce this risk (Theken et al., 2020).
Conclusion
PGx helps bridge this gap by guiding treatment selection based on an individual’s genetic makeup.
- Pharmacogenomics offers a transformative approach to NSAID prescribing by tailoring treatment to an individual’s genetic makeup. For women, who are at greater risk for NSAID-related adverse effects, PGx enables safer and more effective pain management.
Learn more about UGenome.
Personalized Medication Service, ProPEx, or contact UGenome. You can also find case studies for UGenome’s bioinformatics services Metabolite Identification, Bone Metastasis Risk Analysis in Breast Cancer, Survival Analysis with gene signatures in cancer
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