New research suggests melanin may impact the efficacy of drugs within the human body. These shocking findings stem from a recent review paper by Simon Groen and Sophie Zaaijier who work in genome biology. Their research highlights that the medical field has failed to address and research how medicines interact with bodies of different skin pigmentation.
Skin pigmentation has been suggested to act as a “sponge” for some medicines, which raises questions about the usefulness of standardised dosing.
Groen and Zaaijer highlight that diversity is necessary in research and development as well as in clinical trials to ensure healthcare can help people of all races and ethnicities. Zaaijer has said: “Embracing inclusivity is not just an option any more, but a necessity.”
Currently, there is a lack of diversity in clinical trials.
This was demonstrated in a 2020 US clinical trial, where out of 32,000 individuals, only 8% were black, only 6% were Asian, and only 11% were Hispanic.
This lack of diversity in clinical trials may be a consequence of non-white individuals being afraid to partake in such trials, as drug risk profile testing is typically done only on human cells of Northern European descent, meaning that people of colour are taking much higher risks when participating in clinical trials.
New guidelines are being finalised by the United States’ Food and Drug Administration, whose Food and Drug Omnibus Reform Act aims to make diversity a requirement within preclinical and clinical research.
Alongside this, Groen and Zaaijer propose a new research method that uses three-dimensional human skin models with varying degrees of skin pigmentation.
This is part of a much larger issue of disparities in the outcomes of healthcare resources between whites and non-whites. For example, an in-depth report published by the UK government this year highlighted inequities in the performance of medical devices for pregnancy between people with lighter and darker skin tones.
As well as this, research has found that medical students appeared more uncertain when analysing non-white people’s skin conditions. Students are more likely to accurately diagnose skin conditions for white people over non-white people, suggesting that teaching resources for medical students need to include more diverse representations to ensure adequate care for all.
It is apparent that the current medical field consistently demonstrates inequities that disproportionately harm people of colour, including inequities in the efficacy of drugs.
Therefore, it is essential that the medical field adjusts to physiological characteristics of all racial groups. Healthcare which caters to all should be a standard.