Black, Asian adults increasingly represented in atopic dermatitis trials

Key takeaways:

• Racial representation in recent atopic dermatitis trials has largely been representative of the U.S. population.
• Black individuals should be represented more because of disease prevalence rates.

The representation of Black and Asian adults is on the rise in atopic dermatitis clinical trials, according to a study.

As Healio previously reported, people with skin of color are often underrepresented in dermatological clinical trials, with those who are Black or African American being most underrepresented regardless of disease prevalence.

“Disparities in representation may translate into gaps in our understanding of how therapies perform across different racial and ethnic groups,” Jared Jagdeo, MD, MS, associate professor of dermatology and director of the center for photomedicine at SUNY Downstate Health Sciences University and a part of the dermatology service at the Veterans Affairs New York Harbor Healthcare System, told Healio. “Without diverse enrollment, clinicians risk relying on trial data that may not reflect the treatment responses or adverse event profiles of the broader patient population they serve.”

Jared Jagdeo

In this study, Jagdeo and colleagues evaluated the racial and ethnic makeup of 68 recent AD clinical trials with 20,679 patients to analyze how historically underrepresented groups with this indication are currently represented.

Results showed that from 2019 to 2024, 65.4% of patients in the included AD trials identified as white, 17.3% identified as Asian, 13.4% identified as Black or African American, 0.5% identified as American Indian or Alaskan Native, 0.4% identified as Native Hawaiian or Pacific Islander and 1.3% identified as more than one race. For ethnicity, 10.8% identified as Hispanic or Latino.

In comparison, the 2020 U.S. census data report the population to be 61.2% white, 12.4% Black or African American, 5.9% Asian, 1.1% American Indian or Alaska Native, 0.2% Native Hawaiian or Pacific Islander and 10.6% more than one race. Additionally, 19.5% of the U.S. population identified as Hispanic or Latino.

Margaret Kabakova

“While there has been progress in increasing the representation of African American and Asian individuals in AD clinical trials, Hispanic and Latino populations remain significantly underrepresented,” Margaret Kabakova, BS, a medical student at the SUNY Downtown Health Sciences University, told Healio. “With the United States becoming only increasingly more diverse, ensuring that dermatologic research reflects that diversity is critical to improving health equity and advancing patient-centered care.”

Jagdeo and Kabakova also stated that the representation of patients with skin of color in these trials should exceed the U.S. population demographics because they experience higher AD prevalence.

According to the National Eczema Association, patients with skin of color are especially at risk for AD, with a National Health and Examination Survey finding that 19.3% of Black children in the U.S. have AD vs. 16.1% and 7.8% of white and Asian children, respectively.

“Given the higher disease prevalence and unique clinical presentations among racial and ethnic minority groups, equitable representation in clinical trials is essential to ensure that treatment outcomes are generalizable and effective across all populations,” Kabakova said.

To adapt to the growing diversity of the country, the authors recommend multiple approaches.

“Standardized reporting of race and ethnicity, along with expanded access to study sites in underserved areas, can help ensure broader representation,” Jagdeo said. “Collaboration among sponsors, investigators and regulatory bodies is key, as is building trust through community outreach and education to support long-term engagement in dermatologic research.”

For more information:

Jared Jagdeo, MD, MS, can be reached at jared.jagdeo@downstate.edu.

Margaret Kabakova, BS, can be reached at margaret.kabakova@downstate.edu.

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