Lesser response to angiotensin-converting-enzyme inhibitor therapy in black as compared with white patients with left ventricular dysfunction

Exner, D.; Dries, Daniel L.; Domanski, Michael J.; Cohn, Jay N.

doi:10.1016/s1062-1458(01)00390-7

Cited by 161 publications

(211 citation statements)

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“…In other diseases, some drugs that are effective in non-Latino white individuals are ineffective or dangerous for individuals who identify in other racial or ethnic groups (10,(24)(25)(26)(27). By not including minorities in clinical trials, we are potentially losing important information about CF lung disease, especially because members of minority groups tend to have more severe CF lung disease.…”

Section: Discussionmentioning

confidence: 99%

Minorities are Underrepresented in Clinical Trials of Pharmaceutical Agents for Cystic Fibrosis

McGarry

McColley

2016

Annals ATS

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Rationale: Members of racial or ethnic minorities make up an appreciable proportion of patients with cystic fibrosis (CF) and have worse outcomes than non-Latino white individuals. Between 1,999 and 2014, the CF Foundation Patient Registry reported an increase in minorities from 5 to 8.2% for Latinos, from 3 to 4.6% for black individuals and from 1.4 to 3.1% for "Other."Objectives: To evaluate the representation of racial and ethnic minorities in pharmacology clinical trials for CF. Methods:We analyzed pharmacology clinical trials in CF published between 1999 and 2015 by searching PubMed and published study reference lists for qualifying study reports. We examined whether the race and ethnicity of study subjects were reported and, if so, what percentage of subjects represented major minority groups.Measurements and Main Results: Among 147 pharmacology clinical trials, only 19.7% reported the race or ethnicity of study subjects. Latinos were verified as included in 7.5% of clinical trials, black individuals in 6.8%, and Asians in 2.0%. Inclusion of subjects described as "Other race" was reported in 7.5% of trials. In 29 clinical trials that reported race and ethnicity, the percentage of minorities included as subjects was 2.0% for Latinos, 1.0% for black individuals, and 0.1% for Asians.Conclusions: Although CF disproportionately affects non-Latino white individuals, members of other racial or ethnic groups are proportionally underrepresented in CF pharmacology clinical trials. Inadequate inclusion of minorities and failure to report the racial or ethnic background of study subjects limits information about factors influencing drug response and may contribute to health disparities for minorities with CF.Keywords: cystic fibrosis; minority groups; ethnic groups; clinical trials

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Section: Discussionmentioning

confidence: 99%

Minorities are Underrepresented in Clinical Trials of Pharmaceutical Agents for Cystic Fibrosis

McGarry

McColley

2016

Annals ATS

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“…population differences in response rates to drugs used in treating hypertension 46 and depression 47,48 . Broad population categories can be discerned genetically when enough polymorphisms are analyzed, as seen in Figure 3, so these categories are not devoid of biological meaning.…”

Section: S30mentioning

confidence: 99%

“…Much discussion has been devoted to recent findings that hypertensive African-Americans show less response, on average, than hypertensive European-Americans to angiotensin-converting enzyme (ACE) inhibitors 46,57 . A recent meta-analysis showed that the average difference in systolic blood pressure reduction in African-Americans versus European-Americans was only 4.6 mm Hg, and the standard deviations of the change in blood pressure in European-Americans and African-Americans were 12 and 14 mm Hg, respectively 58 .…”

Section: Genetic Variation Race and Medicinementioning

confidence: 99%

Genetic variation, classification and 'race'

2004

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New genetic data has enabled scientists to re-examine the relationship between human genetic variation and 'race'. We review the results of genetic analyses that show that human genetic variation is geographically structured, in accord with historical patterns of gene flow and genetic drift. Analysis of many loci now yields reasonably accurate estimates of genetic similarity among individuals, rather than populations. Clustering of individuals is correlated with geographic origin or ancestry. These clusters are also correlated with some traditional concepts of race, but the correlations are imperfect because genetic variation tends to be distributed in a continuous, overlapping fashion among populations. Therefore, ancestry, or even race, may in some cases prove useful in the biomedical setting, but direct assessment of disease-related genetic variation will ultimately yield more accurate and beneficial information.

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“…Given imperfect information about the patient's health status, doctors have to rely on "easy-to-observe" variables, as age, gender, culture, ethnicity and other life circumstances to improve their inference about the patient's condition. Although the presence of "biological" differences due to race is controversial, there is evidence that members of different races have distinct prevalence rates for certain conditions and respond differently to some drug treatments (Chen et al, 2001;Exner et al, 2001). For example, some depression drugs are metabolized more slowly by African Americans than Whites, and should therefore be administered in lower doses (Lin et al, 1997).…”

Section: Rational Profiling or The Use Of Race-related Information Tomentioning

confidence: 99%

Prejudice, clinical uncertainty and stereotyping as sources of health disparities

Balsa

McGuire

2003

Journal of Health Economics

265

194

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Lesser response to angiotensin-converting-enzyme inhibitor therapy in black as compared with white patients with left ventricular dysfunction

Cited by 161 publications

References 0 publications

Minorities are Underrepresented in Clinical Trials of Pharmaceutical Agents for Cystic Fibrosis

Minorities are Underrepresented in Clinical Trials of Pharmaceutical Agents for Cystic Fibrosis

Genetic variation, classification and 'race'

Prejudice, clinical uncertainty and stereotyping as sources of health disparities

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