Médecine et race

PALO ALTO – Il est très délicat de parler des races, toute suggestion de différences génétiques entre groupes raciaux - au-delà de caractéristiques superficiels tels que la couleur de la peau - risquant de rappeler plus ou moins consciemment le mouvement eugénique du 19° siècle et son rôle dans l'idéologie nazie. Néanmoins le thème longtemps tabou de la génétique raciale réapparaît, car les laboratoires pharmaceutiques cherchent de plus en plus à développer des médicaments qui ciblent tel ou tel groupe racial.

Le débat en cours tourne notamment autour de la question de savoir si la race doit être un critère d'inclusion dans les essais cliniques, et au-delà si la mention d'une race peut figurer dans les indications d'un  médicament. La question est compliquée, mais la réponse est simple : il suffit de se rapporter aux données.

Les essais cliniques n'ont pas pour objectif de prouver l'efficacité d'un traitement (qu'il s'agisse d'un médicament, d'un appareil médical ou d'autre chose) au sein d'un échantillon totalement aléatoire de la population. Les chercheurs préfèrent "enrichir" leur échantillon en utilisant un critère tel que l'âge ou le résultat d'un examen de laboratoire pour sélectionner un groupe de patients pour lequel l'effet du traitement devrait être particulièrement facile à détecter. Depuis quelques années on a de plus en plus recours à des marqueurs biologiques (par exemple certaines séquences d'ADN ou la présence d'un récepteur spécifique pour une molécule donnée) pour sélectionner les sujets qui vont participer à un essai clinique.

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