One interesting finding was that only rheumatology and ophthalmology had positive HLA-B27 rates exceeding the expected U.S. general population prevalence when ordering the testβ highlighting opportunities to refine testing and referral practices.
We analyzed how HLA-B27 testing is used by both rheumatologists and non-rheumatologists across a large healthcare system, focusing on testing patterns, co-testing with other autoantibodies, and referral rates to rheumatology.
Our findings underscore the urgent need for multifaceted and intentional recruitment efforts to ensure that clinical trials better represent the populations they aim to serve.
Excited to share our latest publication on race, ethnicity, and demographic diversity in pivotal psoriatic arthritis (PsA) clinical trials, conducted under the invaluable mentorship of Joerg Ermann and Niti Goel.
https://t.co/Urk7LjmhN9
We found:
- Reporting of race and ethnicity has generally improved, though many journals only report the % of White participants, often omitting data on other racial and ethnic groups.
- Underrepresented racial and ethnic groups face challenges such as transportation issues, childcare obligations, mistrust of the healthcare system, provider biases, and other systemic barriers (e.g. poor infrastructure). Our manuscript explores some strategies to address these.
- Pivotal PsA trials are mostly in North America and Western Europe, with limited representation from Asia, Africa, and Latin America. Recent trial site increases in Eastern Europe and East/Southeast Asia haven't significantly diversified trial populations.
- Although many PsA trial sites were concentrated in racially and ethnically diverse states like California, Texas, and Florida, this diversity was not reflected in the trial populations. Simply having trial sites in diverse states does not guarantee diverse enrollment.
- Racial and ethnic diversity in pivotal PsA trials remains limited, with 92% of participants being White. Notably, this figure has shown little to no change from 2000 to 2020.
@Wissam_Ghusn@Spondy_MD@JoergErmann@SPARTAN_Updates Diversity in axSpA drug trials is improving, but we still have a long way to go.
Greater inclusion by race, ethnicity, gender, and geography is important to ensure trial findings are more applicable to the patients we see in our clinics.
Excited to share our new publication on demographic & geographic diversity in axial spondyloarthritis drug trials!
We analyzed 59 trials (16,000+ participants) since 2000.
Big thanks to the team @Wissam_Ghusn@Spondy_MD@JoergErmann@SPARTAN_Updates!
https://t.co/zJAFioEs4U
@Wissam_Ghusn@Spondy_MD@JoergErmann@SPARTAN_Updates - 53 countries enrolled patients, but very few trials in many regions including Sub-Saharan Africa, South/Central Asia, Latin America and the MENA.
- 92% of trials conducted in high-income countries
- Only 2 trials conducted in low or low-middle income countries.