32 • Specialist clinics What about us? G


A lack of diversity in medical research is putting women and BAME communities at risk. Mattie Lacey-Davidson looks at how coronavirus has highlighted the issue and how it can be tackled


overnment research has revealed that black, Asian and minority ethnic (BAME) Britons


are most at risk from coronavirus. Black people, it found, are four times more likely to die of the virus than white people. Because of this, it’s vital that clinical trials of potential treatments involve a diverse group of test subjects. But studies show this isn’t commonplace in medical research — with women also too often excluded.


BAME exclusion A 2016 study found that only 5% of people from BAME groups in the UK had ever participated in medical research. Without diverse patient representation, it can be difficult to assess how effective treatments are for different groups of people. Innovative Trials, a clinical trial patient- recruitment company, is calling on the medical research community and pharmaceutical sector to come together to tackle the issue of patient diversity in research, particularly in light of the coronavirus outbreak. Kate Shaw, CEO, says, “Patient


diversity is an issue that the global research community and pharmaceutical sector has struggled with for years. While small steps forward have been taken, there’s still more to do. If we’re going to find effective treatments and vaccines for Covid-19 — or any other condition, for that matter — we must all work together to make sure clinical trials represent those most at risk. Otherwise, we risk developing drugs that may not be effective in some population groups.”


IMAGES: GETTY


Gender divides From those conducting research to those participating in trials and even


Healthcare Innovations • Sunday 26 July 2020


animals used for testing, research is male dominated. An example of this is the fact that fewer than 45% of animal studies on anxiety and depression use female laboratory animals, despite women being twice as likely to experience depression as men. Tese studies could result in treatments that are less effective for women than for men — or that have more debilitating side-effects for women. When women are adequately


represented, there’s often a failure to report data by sex. Tis omission can prevent identification of differences that could influence treatment options. “Tis can be disastrous on occasion,” claims Dr Sreedhar Krishna, an NHS consultant. “For example, if a female doesn’t break down medication at the same rate as a male, a therapeutic male dose may lead to a build-up of the drug in a female, thus leading to toxicity.”


Far from representative Clinical research relies on the fact the chosen sample of people can be generalised across the population, but outcomes are often undermined by the failure to diversify those involved. Tis goes beyond ethnicity and gender, but due to an assumed vulnerability other groups are excluded, including children, the elderly, and pregnant women — all of whom require the same access to well-researched treatments. In an attempt to play it safe, research may put these groups at increased risk. “An easy solution for pregnant


women would be to simply keep a register of drugs that are prescribed; this would mean serious side effects would become obvious,” says Dr Sreedhar Krishna.


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WHAT CAN BE DONE? Innovative Trials is calling on


the industry, from funders and researchers to drug manufacturers, to adopt new research strategies. It suggests:


• Designing clinical trials with a focus on patients’ needs, not just treatment outcomes.


• Research community and pharmaceutical companies should work hand in hand with BAME communities to increase their understanding of research and participation in clinical trials.


• There must be a greater focus on how research can be conducted globally, particularly in countries where populations are predominately non-white, to ensure greater diversity.


• Research funders set patient diversity ratios where appropriate to ensure a more equal representation in clinical research.


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