By Paul Kersey
05/23/2022
So…does race exist or not?
Is it a social construct or not?
And what’s with only white people volunteering for clinical trials? It’s almost something constituting Stuff Black People Don’t Like...
National Academies report cites ‘urgent’ need to recruit more diverse participants for clinical trials, by Usha Lee McFarling, StatNews.com, May 17, 2022
The persistent lack of diversity among participants in clinical trials is a critical issue that is harming both populations that have long been left out of pivotal medical studies and the entire biomedical research enterprise, according to the authors of a report released Tuesday by the National Academies of Sciences, Engineering and Medicine.
Describing the need to move away from trials that focus largely on white men as “urgent,” the report’s authors called for a paradigm shift that gives less power to institutions that fund and conduct clinical research and more to communities under study. The sternly worded report said funding to include and recruit more diverse participants should be a priority that is enforced and said such investments could eventually lead to massive cost savings as the nation’s health disparities are reduced.
“An equitable clinical research enterprise would include trials and studies that match the demographics of the disease burden under study,” the report said. “However, we remain far from achieving this goal.”
The report cited many studies that show a lack of diversity persists in clinical trials — even for diseases that disproportionately impact non-white populations. One Food and Drug Administration analysis of clinical trials conducted between 2015 and 2018 showed that 78% of participants were non-Hispanic white people. More than 97% of participants in a Phase 2 trial of the Alzheimer’s drug crenezumab were white and just 2.8% were Hispanic even though Hispanic people are 1.2 times more likely to develop Alzheimer’s, the report said.
This lack of diversity has stubbornly persisted despite decades of attention to the issue, dozens of reports, and the creation of new offices in federal agencies to encourage broader participation in trials. A 2015 Government Accountability Office report found little improvement in trial diversity had occurred since 2004. To this day, the new report said, “research participants remain mostly white and male.”
The report’s authors noted that diversity targets for clinical trials are seldom enforced, and they urged better tracking of the diversity of trial participants, withholding of funding for trials that do not meet goals, and offering tax credits or other financial incentives for those who do increase representation.
To illustrate why diversity in clinical trials is critical, the report’s authors cited the blood clot inhibitor warfarin as a cautionary tale. While the drug has been approved for use since 1951, it was not until 2013 that scientists realized genetic ancestry impacted how the drug should be dosed. Many people with Asian ancestry require lower doses and suffered excess bleeding when the drug was used at dosages set after trials conducted on mostly white men, the report said.
The authors cited other serious issues caused by the lack of diversity, including the inability to generalize research to the larger U.S. population; difficulty recruiting enough participants for many studies, which is the leading cause of clinical trial failure; and a lack of trust in the clinical research and medical establishments by those who have been historically excluded from clinical trials.
If race doesn’t exist, what’s the problem with white people disproportionately volunteering for clinical trials, considering medicine should impact all races equally if race is just a social construct. Right?
Seems like race is more than skin deep after all.
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