Lack of applicable safety data has effected an ease in federal restriction on the inclusion of women in clinical trials, particularly because: (1) they consume more prescription and over-the-counter medications than do men; (2) most require some type of drug therapy during pregnancy; and (3) many drugs that have been withdrawn from the market had higher health risks for women. The desire for more women-specific data prompted the Women's Health Initiative (WHI) studies, which reported an unfavorable risk-benefit relationship for hormone replacement therapy (HRT), as well as no significant reduction in disease or fracture risk with calcium and vitamin D supplementation but possible kidney stone development. Although the health risks were minimal, physicians feared any possible litigation involved with the use of HRT and were concerned with any possible adverse effects from calcium supplementation, and therefore altered their prescribing practices. Women, fearing any long-term health risks, also began seeking alternative treatments. However, the safety of these alternative therapies may be questionable, because they often are not subjected to extensive scrutiny and do not require federal approval. Alternative prescription drug treatments may have long-term adverse consequences that will only become evident with years of use. It is important to recognize that over-generalization and extrapolation of data may deny appropriate treatment to certain subgroups of women who may benefit.

译文

:缺乏适用的安全性数据,使得联邦限制了将女性纳入临床试验的难度,这尤其是因为:(1)与男性相比,她们消耗更多的处方药和非处方药; (2)大多数在怀孕期间需要某种药物治疗; (3)从市场上撤出的许多药物对妇女的健康风险更高。对更多女性特定数据的需求促使妇女健康计划(WHI)开展了研究,该研究报告说激素替代疗法(HRT)的风险-收益关系不利,并且钙和维生素D不会显着降低疾病或骨折的风险补充,但可能有肾结石发展。尽管健康风险很小,但医生担心使用HRT可能引起任何诉讼,并且担心补充钙可能产生的不利影响,因此改变了他们的处方习惯。妇女由于担心任何长期健康风险,也开始寻求替代疗法。但是,这些替代疗法的安全性可能会受到质疑,因为它们通常不会受到广泛的审查,也不需要联邦政府的批准。替代处方药治疗可能会产生长期的不良后果,这种不良后果只有在多年使用后才会显现出来。重要的是要认识到,过度概括和外推数据可能会拒绝为可能受益的某些女性亚群提供适当的治疗。

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