Precision medicine and drug development in Alzheimer's disease: the importance of sexual dimorphism and patient stratification

Front Neuroendocrinol. 2018 Jul:50:31-51. doi: 10.1016/j.yfrne.2018.06.001. Epub 2018 Jun 12.

Abstract

Neurodegenerative diseases (ND) are among the leading causes of disability and mortality. Considerable sex differences exist in the occurrence of the various manifestations leading to cognitive decline. Alzheimer's disease (AD) exhibits substantial sexual dimorphisms and disproportionately affects women. Women have a higher life expectancy compared to men and, consequently, have more lifespan to develop AD. The emerging precision medicine and pharmacology concepts - taking into account the individual genetic and biological variability relevant for disease risk, prevention, detection, diagnosis, and treatment - are expected to substantially enhance our knowledge and management of AD. Stratifying the affected individuals by sex and gender is an important basic step towards personalization of scientific research, drug development, and care. We hypothesize that sex and gender differences, extending from genetic to psychosocial domains, are highly relevant for the understanding of AD pathophysiology, and for the conceptualization of basic/translational research and for clinical therapy trial design.

Keywords: Alzheimer’s disease; Biomarkers; Clinical trials; Gender; Homeostasis; Precision medicine; Precision pharmacology; Sex; Sexual dimorphism; Systems biology.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Biomarkers*
  • Drug Development* / standards
  • Humans
  • Precision Medicine* / standards
  • Sex Characteristics*

Substances

  • Biomarkers