Clinical trial populations may revert to the homogeneity it has taken decades of effort to change.
Have a look at this spreadsheet of recently cancelled NIH grants, and the keywords for which they were “flagged”.
In the early days of the Trump administration’s war on “woke” – a pernicious catch-all that frees the user from having to specify whether they want more racism, misogyny or transphobia with that – we all heard about the supposed mishaps with transgenic mice.
But it gets so much stupider than that.
One study was booted for having the flagged words “trans” and “expression” in it somewhere. The title of this flagrant piece of gender ideology? “Mechanisms underlying the effects of time-restricted feeding on lipid metabolism”.
It appears the word “diverse”, which has diverse applications in science, was enough to get “Functional interrogation of the mouse somatosensory thalamic interneuron in sensory perception and rhythmic states” the arse.
“Status” killed the hopes of a study on “Data-Driven Discovery of Heterogeneous Treatment Effects of Statin Use on Dementia Risk”.
There are scores of them, and like almost everything this so-called government does, it’s comical without being actually funny.
One potentially large effect the anti-DEI push will have is on efforts to, shhh, diversify clinical trial populations, which have famously favoured a narrow age band of pale males who make recruitment and analysis simpler and studies therefore cheaper.
This excellent JAMA article gives a brief history of the diversification of medical trial participants and the reasons for it, and predicts a regression to the cheaper and less complicated mean – why make your trials more tricky and time-consuming when you’re only going to be punished for it?
But as the author (JAMA senior staff writer Rita Rubin) points out, it may be hard to know if this is happening, as the new-look FDA under commissioner Martin Makary may not even publish its study diversity data. The annual Drug Trials Snapshots Summary Report for 2025 is three months overdue.
Will Dr Makary resist the return to lazily unrepresentative data? Given that he responded to questions about clinical trial diversity at his nomination hearing by asking “Are you saying we need to have White people in a trial of sickle cell?”, signs point to no.
The idea that drugs should be trialled on the kinds of people likely to need them is a piece of common sense that has been enshrined in US medical science since the early 90s and still exists in trace amounts on the FDA website, for now, though much related information has been wiped.
Rubin notes, with an admirable lack of snark, that Trump himself falls into at least two underrepresented groups in trials, being over 75 and obese.
Or is he? The oldest president ever sworn in, and possibly the one with the record for lifetime cheeseburgers consumed, “remains in excellent health” and “exhibits excellent cognitive and physical health”, despite highish cholesterol, diverticulitis and a benign polyp, according to the new health report from his personal physician Dr Sean Barbabella.
It’s not quite the “astonishingly excellent” blood pressure of 2018, but his weight is given as 102kg, for a merely overweight BMI of 28.
Blink twice if you need help, Dr Barbabella.
Astonishingly excellent story tips to penny@medicalrepublic.com.au, please.
