Dr Vivienne Hau: Without Representation, Clinical Trials Cannot Adequately Judge Drug Effectiveness

Different populations respond differently to drugs and treatments, but without adequate representation in clinical trials, it will be hard to judge the effectiveness of a new treatment, explained Vivienne Hau, MD, clinical assistant professor with the Kaiser Permanente Bernard J. Tyson School of Medicine.

Transcript

How do racial inequalities in retina research lead to disparities in outcomes and treatment?

If people are not being represented in these studies, then we're not understanding how some of these newer treatments are affecting them as a group, as a whole. As we all know, different ethnic groups may respond differently to certain types of diseases and treatments and outcomes. So, they need to be part of that conversation. They need to be a part of those studies. Unfortunately, many of our clinical trials that we've done today haven't really targeted and ensured that the studies are well representative, that it’s representative of the entire US population.

What's exciting to me is seeing that certain companies are starting to address that need. You know, what's exciting is the ELEVATUM study by Genentech Roche that actually specifically targeted those underrepresented minorities, and I know of other pharma companies in their development of clinical trials that they're starting to look at that, as well. So, those will help answer some of those questions in terms of how maybe in certain types of individuals, some of these treatments are not as effective, because we're not studying in those that we need to. So, that's one area where we really definitely need to do better because of the outcomes.

Now, the other part is that if we don't have representation within the study design, those in leadership, those in organization and planning, then how do we really know those communities that they represent are really being addressed in terms of their needs? And also, recruitment purposes. Being a first-generation immigrant, myself—Vietnamese American—there's a lot of distrust and concerns that my own parents have and my own relatives had of the medical providers, especially those who couldn’t speak their language. So, ensuring that we have greater representation within ophthalmology clinical trials will go a long way in figuring out how we can increase those that we desperately need to be participating in these trials in a better way, because those of us who represent these communities will know how to connect to them.

A lot of it in medicine is really that patient-doctor relationship, and if we're not connecting to them because we don't understand them, because we didn't grow up within the same cultures and communities, then how can we convince them to be a part of some of these clinical trials? And so, it's a responsibility here for us as a field, and also the companies involved in doing this research, to do a better job of including some of these folks within the planning and development of these things.