Underrepresentation of Black and African Americans in RCTs for Lipid Lowering Therapies

In randomized controlled trials (RCTs) for lipid lowering therapies since 1990, Non-Hispanic Black and African American (NHB/AA) patients are underrepresented and results are underreported according to research findings presented at the American College of Cardiology 71st Annual Scientific Session & Expo, from April 2nd through 4th, in Washington, DC.

Researchers sought to investigate the representation and reporting trends of participants in lipid lowering therapy RCTs.

They conducted a retrospective study that included 333,224 participants in the MEDLINE and EMBASE databases between 1990 and 2020. These participants had been enrolled in 42 RCTs for lipid lowering therapies with known atherosclerotic cardiovascular disease benefit. All study sample sizes contained at least 1000 participants and had follow-up of at least 1 year. Researchers examined these studies for race data.

Researchers found 7.3% (95% CI, 0.9%-15.4%) representation of NHB/AA participants enrolled in RCTs of lipid lowering therapy over time, and consistent underreporting of NHB/AA participants in statin and non-statin trials, as well as PCSK9 inhibitor trials. Since 1990, 60% or less of RCTs of statin therapy reported NHB/AA participants. RCTs for ezetimibe or icosapent ethyl did not report any NHB/AA participants.

Researchers concluded that, in RCTs for lipid lowering therapies, Non-Hispanic Black and African American patients are underrepresented and results are underreported. They wrote, “An informed clinician patient discussion should include acknowledgement of these limitations in shared decision-making.”

Reference

Grant JK. Non-Hispanic Black and African American (NHB/AA) Patients: Underreported and Underrepresented in Randomized Controlled Trials of Lipid Lowering Therapy. Presented at: American College of Cardiology 71st Annual Scientific Session & Expo; April 2-4, 2022; Washington, DC.