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CTAD 2025 | Barriers and strategies to ensure equitable participation in Alzheimer’s disease clinical trials

Sid O’Bryant, PhD, Institute for Translational Research at UNT Health, Fort Worth, TX, discusses the most significant barriers preventing equitable participation in Alzheimer’s disease clinical trials, and strategies to overcome these. Dr O’Bryant emphasizes that the barriers to inclusion lie within the scientific community, citing issues such as access to specialty clinics, insurance, and stigma. This interview took place at the 18th Clinical Trials on Alzheimer’s Disease (CTAD) Conference in San Diego, CA.

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Transcript

In the last 20 years, there have been very few, almost no drugs to come out. Yet in the last couple, all of a sudden we have not one, but two new therapies for Alzheimer’s disease and even diagnostics coming out, new blood tests, imaging, et cetera. Representation in those trials in science has been limited. Now the research is showing that these biomarkers that led to therapeutics meeting, hitting market goals are different between different groups...

In the last 20 years, there have been very few, almost no drugs to come out. Yet in the last couple, all of a sudden we have not one, but two new therapies for Alzheimer’s disease and even diagnostics coming out, new blood tests, imaging, et cetera. Representation in those trials in science has been limited. Now the research is showing that these biomarkers that led to therapeutics meeting, hitting market goals are different between different groups. And in my opinion, within the absence of representation of everyone, there will be precision medicine for no one. And in my experience, the barriers don’t lie with the community. The barriers lie with us as the scientific community because we do our research in our clinics, our specialty clinics. Individuals from underserved communities across diseases don’t normally attend specialty clinics. They stay with their primary care doctors where they have that trust built. Then there’s access. So availability and access are not the same thing. Because a clinic is there, doesn’t mean individuals have access to the clinic because there may be a six-month wait list. But that’s actually the smallest barrier. Does the patient have medical insurance that this clinic takes? Can they take off work? Do they have childcare? Then there’s the stigma around dementia and brain diseases itself. So the strategies that we have used to overcome these concerns revolve completely around community relationships. By building community relationships, we then build trust not only with the community, but also with the physicians, the primary care providers, the nurses, the community gatekeepers and organizations. By that holistic, building those connections and ties, we’ve been extremely successful with representation in our research. And so that’s the mission that I’m on at this point is how do we apply those methods more broadly to clinical trials and even access to care?

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