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Clinical trial diversity: An opportunity for improved insight into the determinants of variability in drug response

TitleClinical trial diversity: An opportunity for improved insight into the determinants of variability in drug response
Publication TypeJournal Article
Year of Publication2022
AuthorsGross AS, Harry AC, Clifton CS, Pasqua ODella
JournalBritish Journal of Clinical PharmacologyBritish Journal of Clinical Pharmacology
Volume88
Pagination2700-2717
Type of ArticleArticle
ISBN Number03065251
Accession Number156806392
Keywordsage, CLINICAL pharmacology, clinical trials, diversity, Diversity in clinical trials, DRUG registration, ETHNICITY, government agencies, Patient Advocacy, PRESSURE groups, recruitment, SEX
AbstractAlthough the number of countries participating in pivotal trials submitted to enable drug registration has nearly doubled over the past 25 years, there has not been a substantial increase in the diversity of clinical trial populations. In parallel, our understanding of factors that influence medicine response and variability has continued to evolve. The notion of intrinsic and extrinsic sources of variability has been embedded into different regulatory guidelines, including the recent guideline on the importance of enhancing the diversity of clinical trial populations. In addition to presenting the clinical and scientific reasons for ensuring that clinical trial populations represent the demographics of patient populations, this overview outlines the efforts of regulatory agencies, patient advocacy groups and clinical researchers to attain this goal through strategies to meet representation in recruitment targets and broaden eligibility criteria. Despite these efforts, challenges to participation in clinical trials remain, and certain groups continue to be underrepresented in development programmes. These challenges are amplified when the representativeness of specific groups may vary across countries and regions in a global clinical programme. Whilst enhanced trial diversity is a critical step towards ensuring that results will be representative of patient populations, a concerted effort is required to characterise further the factors influencing interindividual and regional differences in response for global populations. Quantitative clinical pharmacology principles should be applied to allow extrapolation of data across groups or regions as well as provide insight into the effect of patientā€specific characteristics on a medicine's dose rationale and efficacy and safety profiles. [ABSTRACT FROM AUTHOR]
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