Race and Ethnicity Gaps in Global Hidradenitis Suppurativa Clinical Trials

Abstract

Background: Hidradenitis suppurativa (HS) is an often-debilitating disease characterized by chronic and recurrent painful nodules, abscesses, and sinus tracts affecting the intertriginous areas. Despite evidence in the literature of varying prevalence of HS among different racial and ethnic groups, no studies have evaluated the overall generalizability of clinical trial results considering the increased prevalence of HS among African American populations. Additionally, there is a paucity of data exploring the distribution of race and ethnicity in randomized controlled trials (RCTs) for HS. The goal of this analysis is to explore the distribution of race and ethnicity in recent HS RCTs. Summary: Using ClinicalTrials.gov and PubMed, race and ethnicity demographics were extracted from phase II and III trials published from 2000 to August 2019. Fifteen trials were included and among these trials 669 (68.0%) participants were Caucasian and 138 (14.0%) were of African descent. Asians, American Indian or Alaskan Natives, and Native Hawaiian or other Pacific Islanders comprised 29 (2.9%), 3 (0.3%), and 1 (0.1%) participant respectively. Only 15 participants were reported as Hispanic as only three trials reported ethnicity data. The remaining 144 (14.6%) participants were recorded as “other/unspecified” (36 self-identified, 108 lacked race reporting). None of the trials included sub-analysis of treatment efficacy based on race or ethnicity.

What causes hidradenitis suppurativa ?—15 years after

“…Much remains to be learned about the influence of race on the pathogenesis of HS. Unfortunately, the vast majority of HS studies have failed to report participants’ race or ethnicity 60 . Adequate representation of diverse patients across all demographic groups including race and ethnicity is critical to enhancing our understanding of disease pathogenesis and ensuring that treatments can meet the needs of all subgroups affected by this debilitating disease.…”

The most recent advances in understanding and managing hidradenitis suppurativa

“…The remaining 144 (14.6%) participants were recorded as “other/unspecified” (36 self-identified, 108 lacked race reporting). None of the trials included a subanalysis of treatment efficacy based on race or ethnicity 51 .…”

“…One study was conducted solely in Caucasian and Romany individuals 52 , while another study consisted of 80–85% Caucasians 38 . Furthermore, none of the trials reported the percentage of patients who were Hispanic or stratified results by race 51 . The other systemic biologic agent trials for HS (e.g.…”

Attitudes and Behaviors Regarding Sun-Protection Practices Among Minority Groups in a Lower Socioeconomic Community

“…[49] This is especially important in dermatology, as dermatological care has traditionally focused on lighter-skinned and higher SES populations. [1], [2], [50] Figures Figure 1 Percent of racial/ethnic group with respect to their frequency of sunscreen use.…”