¿Puede haber medicina racial?

PALO ALTO – Siempre que se habla de raza pueden surgir dificultades; la menor mención de diferencias genéticas entre grupos raciales (más allá de características superficiales como el color de la piel) puede suscitar recuerdos del movimiento eugenésico del siglo XIX y el lugar que posteriormente tuvo dentro de la ideología nazi. La cuestión de la genética racial fue tabú mucho tiempo, pero ha vuelto a aparecer ahora que la industria farmacéutica está buscando desarrollar medicamentos dirigidos a grupos raciales particulares.

El debate actual gira en gran medida en torno de la cuestión de si la pertenencia racial debería usarse como criterio de inclusión en ensayos clínicos (y por extensión, si los prospectos medicinales deberían hacer mención explícita de la raza). La cuestión es compleja, pero la solución es sencilla: veamos qué dicen los datos.

En la práctica, los ensayos clínicos no pretenden demostrar la eficacia de un tratamiento (fármaco, dispositivo médico u otra clase de intervención) en una muestra totalmente aleatoria de la población general. Más bien, los investigadores “enriquecen” la población de estudio mediante el agregado de alguna característica (por ejemplo, la edad de los sujetos o resultados de análisis de laboratorio), para seleccionar un subconjunto de pacientes en quienes los efectos de la intervención sean más fáciles de detectar que en una población no filtrada. Desde hace algunos años, se está dando cada vez más importancia como criterio de selección de sujetos de estudio a la presencia de ciertos “biomarcadores”, por ejemplo determinadas secuencias de ADN o receptores para un fármaco particular.

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