Minorities Are Underrepresented in COVID-19 Trials, Expert Says
Despite making up a large percentage of COVID-19 deaths, minorities are not seeing adequate enrollment in clinical trials for potential coronavirus treatments.
Edith Mitchell, director of the Sidney Kimmel Cancer Center at Jefferson’s Center to Eliminate Cancer Disparities and former president of the National Medical Association, claimed that studies of possible COVID-19 treatments are not enrolling enough minority participants, despite African Americans, who account for approximately 13 percent of the population, dying from the virus twice as frequently as other racial and ethnic groups.
A multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide that analyzed data from 671 hospitals on six continents showed that of the 96,032 patients whose data were evaluated, only 5,978 (6 percent) were Hispanic, 9,054 (9 percent) were black and 13,519 (14 percent) were Asian.
Additionally, a preliminary report for a 1,063-patient, placebo-controlled trial of remdesivir conducted by the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) enrolled only 134 (12.6 percent) Asian, 219 (20.6 percent) black and 249 (23.4 percent) Hispanic or Latino participants.
At a WCG Clinical webinar last week, Mitchell recommended ways for COVID-19 trials to adequately enroll minorities, including prioritizing their inclusion, developing a formal diversity strategy for recruitment and, during site selection, working with institutions that have connected with minority communities and possess the infrastructure to conduct research.
Trials can also partner with local community organizations, such as churches and other “trust bearers,” to help circulate trial awareness and accessibility, and work with institutions that serve underrepresented populations. In addition, they should consider creating a multilingual targeted recruitment plan for minority communities, she said.
Those tactics can help tackle the representative enrollment issue in the future, she said, adding that looking forward, researchers should foster relationships with minority-based health organizations, community groups and others with close knowledge of minority communities, and work with institutions and investigators that use diversity enrollment plans and prioritize diversifying their trials.