Dr Joe Zein Discusses How Sex, Age Differences Affect Asthma

Joe Zein, MD, PhD, outlines how sex and age differences can impact asthma disease course.

Asthma diagnosis is more common and more severe in younger boys before puberty, said Joe Zein, MD, PhD, a staff physician in the Department of Pulmonary Medicine at Cleveland Clinic. Zein's talk was presented at this year's American Thoracic Society (ATS) annual conference.


What are some of the sex differences in patients with asthma? How do they change across the lifespan?

Epidemiologically, it's very well known that asthma starts is more common, and more severe, in younger boys before puberty. Then after puberty, asthma becomes more severe and common in women and younger girls. Around menopause, it is likely that asthma will also become more severe in men than women. During the lifespan, there is lots of changes in sex hormones, mostly in women during their menstrual cycles, and as they go through puberty and menopause. How these changes in hormones will affect their asthma severity, their lung function, and their health care utilization, whether they will be at a higher risk to go to the emergency department or to the hospital or have exacerbations.

Are there any factors associated with asthma in men and women?

There are lots of differences in exposures, for example, across the lifespan. Maybe for example, construction workers, they are mostly men. They can be women who work in construction, but also they're mostly men and stuff like this that may affect the exposures that will involve them.

Do clinical trials currently reflect these differences?

Clinical trials, yes, they have to balance based on sex. That's important so that you can have a better reflection of how different sexes behave in any disease, not only asthma, any disease.

Are there any implications that can arise if these differences aren't taken into account by providers or patients as they manage their disease?

Absolutely, I'll just give you 2 examples. For example, montelukast, which is Singulair, only works in women, or mostly works in women. For example, for nicotine addiction, the nicotine patch works mostly in men. So if you don't know that information you'll end up giving a medication to one specific gender that may or may not work for that person.

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