Women's Representation in Clinical Trials of Patients with Chronic Kidney Disease

Overview

Journal Clin Kidney J

Publisher Oxford University Press

Specialty Nephrology

Date 2023 Sep 4

PMID 37664564

Authors

Ana-Catarina Pinho-Gomes

Cheryl Carcel

Mark Woodward

Carinna Hockham

Affiliations

Soon will be listed here.

Abstract

Background: Sex and gender differences in chronic kidney disease (CKD), including epidemiology and response to treatment, remain poorly understood. This study aimed to investigate how women are represented in CKD clinical trials and whether sex- and gender-disaggregated outcomes were reported.

Methods: Clinical trials on CKD were identified from ClinicalTrials.gov. Randomised, phase 3/4 trials with ≥100 participants were selected to quantify women's representation among participants by computing the participation:prevalence ratio (PPR) and investigating whether sex-disaggregated analyses had been performed.

Results: In total, 192 CKD trials registered on ClinicalTrials.gov and published between 1995 and 2022 were included. Overall, women accounted for 66 875 (45%) of the 147 136 participants. Women's participation in clinical trials was lower than their representation in the underlying CKD population globally (55%). The PPR was 0.75 (95% confidence interval 0.72-0.78), with no significant variation irrespective of mean age, CKD stage, dialysis, location, type of intervention or funding agency. A total of 39 (20%) trials reported sex-disaggregated efficacy outcomes and none reported sex-disaggregated safety outcomes.

Conclusion: Women's participation in CKD clinical trials was lower than their representation in the underlying CKD population. Sex-disaggregated efficacy and safety outcomes were rarely reported. Improving women's enrolment into clinical trials is crucial to enable sex- and gender-disaggregated analysis and thus identify potential differences in treatment response between women and men.

Citing Articles

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Advancing Healthcare Equity in Nephrology: Addressing Racial and Ethnic Disparities in Research Trials and Treatment Strategies.

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Sex disparities in mortality and cardiovascular outcomes in chronic kidney disease.

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Novel Perspectives in Chronic Kidney Disease-Specific Cardiovascular Disease.

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Cardiovascular disease in older women with CKD.

Radley A, Lees J, Stevens K Clin Kidney J. 2023; 16(12):2304-2308.

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