Meta-analysis of 115 acute #stroke randomized controlled trials conducted within the last decade shows women were under-enrolled by 5 percentage points.
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The inadequate enrollment of women in randomized clinical trials (RCTs) has been a long-standing issue in clinical medicine.1 Despite efforts to increase their representation, recent analyses provide evidence that disparities persist in the participation of women in clinical trials of various cardiovascular diseases, including stroke.2-9 In the past decade, significant progress in acute stroke therapy has been made, including treatment of large-vessel occlusions with mechanical thrombectomy,10-12 reduction in the risk of recurrent stroke with dual antiplatelet therapy,13,14 and advances in neuroprotection.15 However, given the well-documented importance of sex in the epidemiology and pathophysiology of stroke,16 the possible underenrollment of women in these and other stroke trials represents a threat to their generalizability and in turn to the validity of the evidence base with regards to the treatment of women. It also introduces the potential for unequal access to novel treatments.
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