New england moves11/6/2022 Race has long been a factor in the prescribing of angiotensin-converting–enzyme (ACE) inhibitors. Basing the indication for BiDil on self-identified race ignores the many underlying social and biologic factors that influence both development of disease and response to treatment. 1 Supporters hailed BiDil as a step toward personalized medicine that might provide better outcomes for self-identified black patients with heart failure, while critics contended that race alone is insufficient to determine who can or cannot benefit from the drug and that some people who could benefit might not receive it. This approval, which was not based on known pharmacogenomic variation, sparked controversy over using race in prescribing and dosing of drugs and the scientific and ethical justifications for approving a drug for only one racial group. Eventually, precision medicine may revolutionize our understanding of race and its utility (or lack thereof) in clinical practice.Ī decade ago, the Food and Drug Administration (FDA) approved the first race-based drug, BiDil, a combination of the generic drugs isosorbide dinitrate and hydralazine hydrochloride, as a treatment for heart failure in self-identified black patients. Prescribing medications on the basis of race oversimplifies the complexities and interplay of ancestry, health, disease, and drug response. The challenge for clinicians, however, is that self-identified race does not predict the genotype or drug response of an individual patient. It is widely accepted that self-identified race often correlates with geographical ancestry, that geographical ancestry is a major determinant of genomic variation, and that genomic variation can influence reactions to drugs. Health care providers have long struggled with the utility of race in the prescribing and dosing of medications. The most trusted, influential source of new medical knowledge and clinical best practices in the world. #NEW ENGLAND MOVES LICENSE#Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. #NEW ENGLAND MOVES TRIAL#NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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