Race is Irrelevant to Drug Studies, Say Geneticists
August 1, 2003
Ancestry reflects something genetically real, explaining why forensics can identify a skeleton's race, says anthropologist C. Loring Brace of the University of Michigan, Ann Arbor. However, biologists say there is little medical value to knowing a patient's race.
The Food and Drug Administration has issued a "draft guidance" to scientists running clinical trials of new drugs, recommending that they ask participants which of 10 groupings their race and ethnicity falls into.
The premise is that physiological response to a drug reflects genes. However, prominent geneticists are warning that although response to medication partly reflects a patient's genes, it is rarely the genes that reflect race that matter. Thus self-reported race is misleading and may be medically useless:
- Six million Americans in the 2000 census picked two or more races to describe themselves.
- Blacks respond differently than whites to some heart drugs, but genetics indicates that it is much narrower, more precise groupings of ancestry or ethnicity that account for such differences, rather than race.
- Sickle-cell anemia, for instance, is more common in parts of sub-Sahara Africa than it is globally, but focusing prevention efforts on blacks would miss millions of southern Italians, eastern Mediterraneans, Middle Easterners and southern Indians who also carry the defective gene.
- Scientists report that 93 percent to 95 percent of genetic variations reflect within-group differences, while less than 5 percent reflect differences between races.
Knowing ancestry, by contrast, could well prove useful in understanding variable responses to drugs. Best of all is a patient's actual genetic information.
Source: Sharon Begley, "Scientifically, Race Is Skin Deep, And It's Not Always That Useful," Science Journal, Wall Street Journal, August 1, 2003.
For WSJ text
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