Eligibility Rates among Racially and Ethnically Diverse US Participants in Phase 2 and Phase 3 Placebo‐Controlled, Double‐Blind, Randomized Trials of Lecanemab and Elenbecestat in Early Alzheimer Disease
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Medientyp:
E-Artikel
Titel:
Eligibility Rates among Racially and Ethnically Diverse US Participants in Phase 2 and Phase 3 Placebo‐Controlled, Double‐Blind, Randomized Trials of Lecanemab and Elenbecestat in Early Alzheimer Disease
Erschienen in:
Annals of Neurology, 95 (2024) 2, Seite 288-298
Sprache:
Englisch
DOI:
10.1002/ana.26819
ISSN:
0364-5134;
1531-8249
Entstehung:
Anmerkungen:
Beschreibung:
ObjectiveMany factors contribute to inadequate diversity in Alzheimer disease (AD) clinical trials. We evaluated eligibility rates among racial and ethnic groups at US sites in large global multisite trials in early AD.MethodsUsing screening data from 4 randomized, double‐blind, placebo‐controlled clinical trials in early AD, we assessed rates of eligibility among racial and ethnic groups controlling for other demographic covariates. Each trial incorporated positron emission tomography and/or cerebrospinal fluid to evaluate brain amyloid pathology, as well as typical eligibility criteria used in early AD trials.ResultsAcross the trials, 10,804 US participants were screened: 193 (2%) were of Hispanic ethnicity and Black race, 2,624 (25%) were of Hispanic ethnicity and White race, 118 (1%) were of non‐Hispanic ethnicity (NH) and Asian race, 696 (7%) were of NH ethnicity and Black race, and 7,017 (65%) were of NH ethnicity and White race. Data from 156 participants who did not fit into these categories were excluded. Accounting for age, sex, and trial and using NH White participants as a reference group, we observed higher probabilities of ineligibility for amyloid biomarker criteria among Hispanic Black (odds ratio [OR] = 3.20, 95% confidence interval [CI] = 2.11–4.88), Hispanic White (OR = 4.15, 95% CI = 3.58–4.83), NH Asian (OR = 2.35, 95% CI = 1.23–4.55), and NH Black (OR = 3.75, 95% CI = 2.80–5.06) participants.InterpretationDifferential eligibility may contribute to underrepresentation of some minoritized racial and ethnic groups in early AD trials. Amyloid biomarker eligibility is a requirement to confirm the diagnosis of AD and for treatment with amyloid‐lowering drugs and differed among racial and ethnic groups. ANN NEUROL 2024;95:288–298