Exclusion of Elderly People from Randomized Clinical Trials of Drugs for Ischemic Heart Disease

Objectives To measure exclusion of elderly adults from randomized trials studying drug interventions for ischemic heart disease ( IHD ) and describe the characteristics of these trials. Design Cross‐sectional analysis. Setting Interventional clinical trials studying a drug intervention for IHD that started in 2006 and after were identified in ClinicalTrials.gov. Data were extracted on study features, including age‐based inclusion criteria. Data on participants and their age distribution were collected from trial publications, investigator inquiry, and result data in ClinicalTrials.gov. Participants Individuals aged 65 and older. Measurements Proportion of trials excluding individuals based on age, mean age of trial participants, and proportion of enrolled participants aged 65 and older and 75 and older. Results Of 839 identified trials, 446 (53%) explicitly excluded elderly adults. The most‐frequent upper age limits were 80 (n = 164) and 75 (n = 114), with a median upper age limit of 80 (interquartile range 75–80). Trials with upper age limit exclusions tended to be smaller (median number of participants 100 vs 201, P < .001) and were more likely to be funded primarily by nonindustry sources (78.3% vs 70.0%, P = .006). The overall mean age of trial participants was 62.7 (mean maximum age 74). The estimated proportion of participants aged 65 and older was 42.5% and the estimated proportion aged 75 and older was 12.3%. Conclusion Despite the high burden of IHD in elderly adults, the majority of drug trials do not enroll participants reflective of age‐related prevalence of the disease.