Adequate enrollment of women in cardiovascular drug trials and the need for sex-specific assessment and reporting

American Heart Journal Plus

卷:17

Cody Parsons¹  Corinne Carland²  Barinder Hansra³  Radmila Lyubarova⁴  Abha Khandelwal⁵ 

[1] Cardiovascular Health, Stanford Health Care, United States of America;

[2] Department of Medicine, University of Pennsylvania, United States of America;

[3] Division of Cardiology and Department of Critical Care Medicine, UPMC, United States of America;

[4] Division of Cardiology, Albany Medical College, United States of America;

[5] Division of Cardiology, Stanford School of Medicine, United States of America;

关键词: Sex differences;    Women's cardiovascular disease;    Pharmacology;    Clinical trials;    Female;    Disparities;   

DOI  :  

来源: DOAJ

【 摘 要 】

Cardiovascular disease (CVD) is the leading cause of death for women in the United States and globally. There is an abundance of evidence-based trials evaluating the efficacy of drug therapies to reduce morbidity and mortality in CVD. Additionally, there are well-established influences of sex, through a variety of mechanisms, on pharmacologic treatments in CVD. Despite this, the majority of drug trials are not powered to evaluate sex-specific outcomes, and much of the data that exists is gathered post hoc and through meta-analysis. The FDA established a committee in 1993 to increase the enrollment of women in clinical trials to improve this situation. Several authors, reviewing committees, and professional societies have highlighted the importance of sex-specific analysis and reporting. Despite these statements, there has not been a major improvement in representation or reporting. There are ongoing efforts to assess trial design, female representation on steering committees, and clinical trial processes to improve the representation of women.This review will describe the pharmacologic basis for the need for sex-specific assessment of cardiovascular drug therapies. It will also review the sex-specific reporting of landmark drug trials in hypertension, coronary artery disease (CAD), hyperlipidemia, and heart failure (HF). In reporting enrollment of women, several therapeutic areas like antihypertensives and newer anticoagulation trials fare better than therapeutics for HF and acute coronary syndromes. Further, drug trials and cardiometabolic or lifestyle intervention trials had a higher percentage of female participants than the device or procedural trials.

【 授权许可】

Unknown