Diversity in Alzheimer's disease drug trials: The importance of eligibility criteria.

Diversity in Alzheimer's disease drug trials: The importance of eligibility criteria.
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DOI:
10.1002/alz.12433
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发表时间:
2022-04
期刊:
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子:
--
通讯作者:
Papma JM
Papma JM
中科院分区:
其他
文献类型:
--
作者:
Franzen S;Smith JE;van den Berg E;Rivera Mindt M;van Bruchem-Visser RL;Abner EL;Schneider LS;Prins ND;Babulal GM;Papma JM

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为了推广安全性和有效性研究结果,在阿尔茨海默病(AD)药物试验中充分代表不同人群是至关重要的。在这篇综述中,我们的目的是调查疾病修饰性AD试验中受试者的多样性,以及受试者资格标准的频率。使用Medline、Embase、Cochrane图书馆和Clinicaltrials.gov进行系统评价,确定了2247条记录。在101项纳入的AD试验中,参与者主要是白人(中位数百分比:94.7%,四分位数范围:81.0-96.7%);随着时间的推移(2001-2019年),这一比例没有显着增加或减少。排除精神疾病患者(78.2%)、心血管疾病患者(71.3%)和脑血管疾病患者(68.3%)、有义务的照顾者出席(80.2%)和特定的迷你精神状态检查分数(90.1%;没有随着时间的推移而显著增加/减少)等资格标准可能导致不成比例地排除了不同种族的个体。在阿尔茨海默病临床试验中,不同种族的参与者仍然代表性不足。提出了几项建议,以扩大资格标准。
To generalize safety and efficacy findings, it is essential that diverse populations are well represented in Alzheimer's disease (AD) drug trials. In this review, we aimed to investigate participant diversity in disease‐modifying AD trials over time, and the frequencies of participant eligibility criteria. A systematic review was performed using Medline, Embase, the Cochrane Library, and Clinicaltrials.gov, identifying 2247 records. In the 101 included AD trials, participants were predominantly White (median percentage: 94.7%, interquartile range: 81.0–96.7%); and this percentage showed no significant increase or decrease over time (2001–2019). Eligibility criteria such as exclusion of persons with psychiatric illness (78.2%), cardiovascular disease (71.3%) and cerebrovascular disease (68.3%), obligated caregiver attendance (80.2%), and specific Mini‐Mental State Examination scores (90.1%; no significant increase/decrease over time) may have led to a disproportionate exclusion of ethnoracially diverse individuals. Ethnoracially diverse participants continue to be underrepresented in AD clinical trials. Several recommendations are provided to broaden eligibility criteria.
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