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Diversity in Alzheimer's disease drug trials: The importance of eligibility criteria
Author(s) -
Franzen Sanne,
Smith Jade Emily,
den Berg Esther,
Rivera Mindt Monica,
BruchemVisser Rozemarijn L.,
Abner Erin L.,
Schneider Lon S.,
Prins Niels D.,
Babulal Ganesh M.,
Papma Janne M.
Publication year - 2022
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.12433
Subject(s) - medicine , interquartile range , clinical trial , disease , cochrane library , medline , alzheimer's disease , gerontology , psychiatry , family medicine , randomized controlled trial , political science , law
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. Methods A systematic review was performed using Medline, Embase, the Cochrane Library, and Clinicaltrials.gov, identifying 2247 records. Results 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. Discussion Ethnoracially diverse participants continue to be underrepresented in AD clinical trials. Several recommendations are provided to broaden eligibility criteria.