Dear Editor,

We thank YanRan Qiu and Jing Sun for their interest in our work [1, 2]. They acknowledge problems associated with using race as the primary variable for understanding efficacy and safety of pharmacological treatments. In their letter, Qiu and Sun emphasize points we made in the article introduction and in the discussion of our results [2]. Thus, there is no disagreement between us. We also assert that the results presented need to be interpreted in the context of race as a social construct. As such, racial disparities in treatment outcomes most likely reflect broader differences in socioeconomic factors and access to care. We initially aimed to assess participants’ socioeconomic status and social determinants of health in our analyses. Unfortunately, such variables were not fully captured in the primary studies, and we could not design analyses that addressed this aim.

Several pharmaceutical companies have publicly committed to achieving racially and ethnically diverse participation in their global clinical trials [3]. This aligns with current guidance from key regulatory authorities 4,5,6]. The focus on diversity in clinical trials and better collection of more granular demographic data will allow for future studies on the impact of socioeconomic, cultural, and practice-based differences that underpin discrepancies in treatment outcomes.