BDO: Why is it important for African Americans to participate in clinical trials?
Dr. Linda Bradley: African Americans really do need to participate in clinical trials. The new drug that we’re looking at, for instance, I just wrote a paper or what we call an editorial, where I read a paper they asked me to comment on it, looking at two groups of women Black and White. With a standard dose of a medication of a drug called ulipristal. This drug is available in Canada in France and in many parts of Europe. But it turns out the standard dose of 5mg of ulipristal compared to 10mg is different in terms of the outcome.
The trial was almost 50/50 Black White and patients were asked to participate fill out a questionnaire, start the ulipristal, take it for three months. How did you feel, how are your periods, did you have pain, did you get better? Black women weren’t as happy on 5mg, White women were. It may be that the burden of our disease from fibroids. We don’t know why genetically it’s different, just bigger fibroids more massive.
Doctors are looking at precision medicine also called personal medicine. But we may find in certain situations that we may have to have ethnocentric dosing. Maybe a Black woman gets 10mg of this drug a White person 5mg, maybe it’s the weight. It’s important when we look at clinical trials and outcomes, just like birth control pills, we’re finding that women that are really over their ideal body weight over 198lbs they have a higher pregnancy rate than normal weight women.
I’m saying that it doesn’t work but on some of the studies just look at I’m just taking this separately for birth control they work. But the women that got pregnant who swore and we could tell that they took their pills every day we’re more likely overweight. So even with the morning-after pill, you have sex, condom breaks didn’t use a condom we have something caught Plan B you can buy it over the counter doesn’t work as well in obese women.
The same thing with fibroids we have to sort of look at the individual, we have to study that whole woman. Every woman is different genetically, biologically, spiritually very different. So when we’re looking at trials it’s important for black women to be a part of trials to see do we behave different in terms of our outcomes. We only know these things by participating.
The days of being a guinea pig we’re not looking at this but this helps us to offer care to so many of our sisters in years to come. For better outcomes it takes study and without study, we kind of stay stuck. It’s just we’re finding that we are more alike than different but sometimes we really are different. It just takes us to look at all kinds of patient populations to know what works better