AstraZeneca reviews diversity in trials to ensure drugs work for all

A major review of diversity across its trials is being conducted by the pharmaceutical giant, although it admits that including pregnant women is a particular challenge.

David Fredrickson, head of oncology at Britain's biggest drugmaker, told the Guardian that the firm was among those leading efforts to improve participation of people of colour and other under-represented groups in clinical trials.

He said it was applying an equity lens to every phase of the medicine's lifecycle.

Drugs and medical equipment that are less effective in certain groups may be developed because of a lack of diversity among volunteers participating in clinical trials.

Fredrickson admitted that pregnant women are one of the more challenging issues to tackle.

The situation meant that that group was excluded from trials for coronaviruses vaccines, and public confusion over whether the shots were safe for pregnant women ultimately led to a low take. A major review found that the jabs are safe and reduce the risk of stillbirth.

A disproportionate number of those in hospital with Covid were unvaccinated pregnant women, despite the fact that they were advised to bevaccinated. One study found that one in six Covid patients needed the most intensive treatment.

The number of pregnant women taking the vaccine rose from 23% in August to 54% at the end of last year.

The UK health secretary, Sajid Javid, has launched a review into why people of colour and women have worse health outcomes.

Early studies of Covid vaccine, including an Oxford trial conducted by AstraZeneca, were criticized for mainly involving white participants, despite the fact that the virus has a disproportionately larger effect on people of colour. The firm and others ran large trials involving thousands of volunteers around the world.

Fredrickson described the effort to catalogue what is the state of the union of the trials of the company. There are early signs that it has good representation of different groups.

Fredrickson said the pharma industry was working towards better representation of women, people of colour and Latinx people. He said he was not aware of a specific effort, but that they were going to need to move.

He said that the industry was taking a hard look at the eligibility criteria for clinical trials of new medicines. People with type 2 diabetes are excluded from many cancer trials.

In the year to November 2020, the highest percentage of all ethnic groups were overweight or obese, according to official figures.

Bringing trials to patients by allowing them to join trials from the comfort of their homes is one way of improving diversity.

Fredrickson is due to speak about lung cancer at the meeting in the Swiss resort on Wednesday, a day after he spoke about the future of health in the global south.