Racial and ethnic trends in antiseizure medications trial enrolment: A systematic review using ClinicalTrials.gov

Wan Yee Kong; Hamidreza Saber; Rohit Marawar; Maysaa Merhi Basha

doi:10.1016/j.eplepsyres.2021.106613

Racial and ethnic trends in antiseizure medications trial enrolment: A systematic review using ClinicalTrials.gov

Epilepsy Res. 2021 Jul:173:106613. doi: 10.1016/j.eplepsyres.2021.106613. Epub 2021 Mar 11.

Authors

Wan Yee Kong¹, Hamidreza Saber², Rohit Marawar³, Maysaa Merhi Basha⁴

Affiliations

¹ Department of Neurology, Wayne State University, Detroit Medical Centre, Michigan University Health Center, 4201 St Antoine A, Detroit, MI, 48201, United States. Electronic address: wyeekong@hotmail.com.
² Department of Neurology, University of California, Los Angeles 710 Westwood Plaza, Los Angeles, CA, 90095-1769, United States. Electronic address: hsaber@mednet.ucla.edu.
³ Department of Neurology, Wayne State University, Detroit Medical Centre, Michigan University Health Center, 4201 St Antoine A, Detroit, MI, 48201, United States. Electronic address: ramarawar@med.wayne.edu.
⁴ Department of Neurology, Wayne State University, Detroit Medical Centre, Michigan University Health Center, 4201 St Antoine A, Detroit, MI, 48201, United States. Electronic address: mmerhi@med.wayne.edu.

PMID: 33743520
DOI: 10.1016/j.eplepsyres.2021.106613

Abstract

Objective: To describe the racial and gender distribution in antiseizure medications (ASM) clinical trials using a systemic review of clinical trial registry database.

Methods: We searched ClinicalTrials.gov database for ASM trials registered from September 1988 to January 2019. All randomized and non-randomized trials investigating ASM for epilepsy were included. Trials with intervention other than ASM or condition other than epilepsy were excluded. Data on age, race, ethnicity, and gender were extracted directly from database and from published data where available. Study location, trial identifier, year of completion, and funding sources were also collected. Meta-analysis of proportions was conducted using R software.

Result: Two hundred and thirty studies conducted globally with 39,576 participants were included. Overall, there are 53 % male on all registered ASM studies globally. For trials conducted in the United States (61 studies/5126 participants), 52 % of the participants were male with the following weighted racial distribution (80 % White 13 % Black 3% Asian 7% Hispanic). Subgroup analysis revealed that non-pharma-sponsored studies (50 studies, 4296 participants) have a higher representation of minorities as compared to pharma-sponsored studies (180 studies, 35,280 participants), including Hispanic (9% vs 3% respectively) and Black (18 % vs 11 % respectively). Temporal trends in racial distribution were noted when the duration of 2007-2019 was split into two groups: 2007-2013 (0% Asian, 5% Hispanic, 20 % Black); 2014-2019 (4% Asian, 7% Hispanic, 8% Black).

Conclusion: In this systematic review, participation of racial and ethnic minorities of Asian and Hispanic background was under-represented. Disparities of all minorities including Black participants was more notable over time and in studies sponsored by industry. Generalizability of ASM clinical trials to certain subgroups should be further examined.

Keywords: Age disparity; Antiseizure medications; Clinical trials; Gender disparity; Racial disparity.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Clinical Trials as Topic
Ethnic and Racial Minorities
Ethnicity*
Female
Humans
Male
Minority Groups*
Patient Selection*
Seizures / drug therapy
United States