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A study confirms that Golimumab is much less effective in Black patients, resulting in lower remission rates in Black IBD patients and much lower endoscopic healing rates when compared to White patients.

To date, most studies on health disparities have focused on issues like access to healthcare, socioeconomic factors, and so on. There has also been considerable research focused on the epidemiology of diseases among various racial groups and factors contributing to these differences. 

However, there are still insufficient studies regarding responses to various treatments in different racial groups. Recognizing and reversing this is vital to achieving equal health outcomes among various population groups.

Another challenge to achieving research equity is that clinical studies continue to be predominantly conducted in the majority population group, which, in the US, is currently White people.

This study, published in the journal Inflammatory Bowel Diseases, focused on identifying differences in the efficacy of golimumab in ulcerative colitis between various racial groups. 

It is already known that IBD diseases like Crohn’s have different clinical manifestations in different racial groups. Thus, for example, despite a lower prevalence of Crohn’s disease in the Black population, higher rates of penetrating and perianal Crohn’s disease and a greater likelihood of disease-related complications have been reported for Black patients, resulting in greater rates of adverse clinical outcomes.

Although many factors are known to influence disease outcomes in different racial groups, there are insufficient studies regarding responses to drug therapies among various racial groups.

Black Patients Benefit Significantly Less from Golimumab

Golimumab is an immunosuppressive drug that targets and inhibits tumor necrosis factor-alpha (TNF-alpha), a key cytokine involved in the inflammatory response. By blocking TNF-alpha, golimumab helps to reduce inflammation and alleviate symptoms in patients with ulcerative colitis. 

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For the present study, researchers analyzed the pooled data from phase 2 and phase 3 drug trials that were available through the Yale Open Data Access Project. The study included 1006 participants from the golimumab induction trial, only 18% of whom were of racial minorities, and 783 participants from the golimumab maintenance trial, of whom 17% were of racial minorities. Nonetheless, the study had many interesting and relevant findings when comparing responses among various racial groups.

The study found that, compared to Whites, Blacks had much lower clinical response and clinical remission rates. Further, Blacks also had much lower endoscopic healing at 6 weeks and 30 weeks. However, there was no such difference in the placebo groups. 

The Bottom line

This study clearly shows that racial minorities, especially Blacks, are much less likely to achieve disease remission through golimumab therapy. The study also shows how the efficacy of drug therapies may vary between racial groups, which may further contribute to health inequalities. Hence, researchers concluded that there is a need for more clinical studies to establish the efficacy of biological therapy in ethnic minorities.

Source:

Greywoode, R., Petralia, F., Ullman, T., Colombel, J. F., & Ungaro, R. C. (2022). Racial difference in efficacy of golimumab in ulcerative colitis. Inflammatory Bowel Diseases, 29(6), 843–849. https://doi.org/10.1093/ibd/izac161