Diabetes is high in the black population, in fact it’s about double that of the white population with around 13% of black Americans suffering from the illness.
That’s a high percentage, yet looking at clinical trials, black people are hugely underrepresented.
The Lancet Diabetes and Endocrinology wrote that:
The US Food and Drug Administration (FDA) has mandated that new glucose-lowering drugs must be tested for cardiovascular safety. As treatment choices for type 2 diabetes evolve from a one-size-fit-all approach into a model based on patient-centred precision medicine, there is a need for deeper understanding of the clinically meaningful pharmacogenomic and pharmacokinetic differences between individuals receiving such therapies to determine if there are variations in their potential effect, including differences in cardiovascular outcomes for different racial and ethnic groups.1
Constituting 12·6% of the population in the USA, black or African American people have one of the highest rates of type 2 diabetes (13·2%), a burden that is almost twice that of non-Hispanic white people (7·6%).2, 3 Additionally, mortality rates for cardiovascular disease are also disproportionately higher for this minority group.4 Therefore, there is an opportunity for new therapies to be especially beneficial for such groups. However, there is also a need to ensure that these treatments are as effective and safe for black and African American people and other minorities as for non-Hispanic white people.
To determine the clinical trial representation of black or African American people, we reviewed the published data from the seven cardiovascular outcome trials instigated by the 2008 FDA mandate for evaluating cardiovascular risk for new therapies in type 2 diabetes: EXAMINE, EMPA-REG, SAVOR-TIM 53, ELIXA, TECOS, LEADER, and SUSTAIN-6 (appendix). The reported participation of black or African American people in these mega-trials was less than 5% in five of the seven trials. Furthermore, the description of race or ethnicity was not consistent; only two of seven trials collected these data as suggested by the US National Institutes of Health.
So, basically, despite a rate of 13% suffering, only 5% of those in trails are black! A serious underrepresentation.
The Huffington Post wrote:
When drug trial participation isn’t balanced across gender, race, ethnicity and socioeconomic status, it can be easy to miss critical distinctions in how treatments may work in different types of people, said Dr. Keith Ferdinand, of Tulane School of Medicine in New Orleans. “Certain groups of patients may respond differently to the same therapies.”
There are examples beyond just diabetes. For example, studies have found two types of blood pressure drugs don’t work as well in black patients as other people, and one medicine for heart failure works very well in black patients but not in white patients, Ferdinand, who wasn’t involved in the study, said by email.
“For some time we have known high risk minority populations have been underrepresented in clinical trials,” said Dr. Daniel Lackland, a researcher at Medical University of South Carolina who wasn’t involved in the study.
We really have to question why this is happening! In all likelihood it’s money related, maybe medicine for white people is just worth more to the companies. if that is the case what can be done about it? We all know the drug industry is a capitalist industry like all others! Many many lives could be saved with the right targeted drugs.
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