Sex bias in medical research

[OddBoots]

I have just been catching up on the BBC R4 Inside Science podcast and there is a really interesting report at the start of the 29th June episode available here with the same study in New Scientist here and the original paper being published by UCL here

It reports on what sounds to be a huge study carried out by teams all over the world that show that the biological differences between the sexes are far greater than anyone realised, in every cell and system not just reproductive.

The study is mouse based because that matches how early drugs are tested but the background is what has been noticed about how drugs work differently in human women compared to men.

From the New Scientist article:
"These sex nuances mean that drugs optimised for male animals may be less effective in females, or even cause harm, says Karp. Between 1997 and 2001, 8 of the 10 drugs that were pulled from the market in the US posed greater health risks for women – possibly as a result of male-biased animal research, she says.

Moreover, the male bias means that drugs that work better in females could be overlooked and never make it into clinical trials in the first place, because they are only tested in male animals, says Karp."

I am sure the intentions in research have on the whole been good but it does go to show how much the way we default to 'male' when thinking 'people' and the wider implications of that.

This has been a massive historical issue.

It should be noted these clinical trials were performed were on white males. Women and anyone is isn't white have not been well represented in clinical trials.

I would say things are improving though.

Very true, in the UK at least, a lot of the medical research I have read of late has been conducted in China and Japan so I would have thought there would have been those nationalities represented but that leaves a lot of the world and other ethnic groups.

Yes, ongoing massive issue.

At least it is a bit better recognised now

Yes, it's a well recognised huge issue with roots in the male ownership of knowledge and the consignment of women to the role of the childbearing other. Occasionally, the underrepresentation of women in medical research has been justified by the fact that they may be pregnant, rendering any results unreliable, but also throwing up ethical questions that are absent when experimenting on men.

There is a PhD in that, or a thousand. I wish more doctors were interested in addressing this issue.

I run drug trials, and for phase I studies it is pretty unavoidable, except perhaps for some chemo drugs or know effect drug classes.
For later phase there is certainly more of a 50:50 split now.
Trials are now run internationally and most of the time the aim is to ensure they are as ethnically diverse a state possible.

I find this bizarre, because almost every study i read uses female animals (they don't fight, so can be caged together, which is cheaper). It is standard in infection / drug responses to use female mice and rats. I don't recognise this at all (clinical trials different issue ).

bigkidsdidit
I'm surprised to hear that. Male rats are cheaper than the females, which are kept back for for breeding. And the lab strains are bred to be more docile.

It may be field specific. In my field the basic biological differences between male and female mice, and the impact of that on disease, is being discussed a lot now with the result that researchers are being urged to use male mice occasionally