Racial and ethnic underrepresentation in dermatology clinical trials

Background: Including participants of diverse racial and ethnic populations in clinical trials is important to reduce disparities and promote health care equity.Objective: To evaluate racial and ethnic representation in dermatology clinical trials.Methods: Participant data from dermatology trials completed in the United States from 2017 to 2021 from ClinicalTrials.gov were compared to census data to determine if minority groups were represented at rates that reflect population demographics. Participation was compared with prevalence rates for the most underrepresented racial group.Results: Of 246 trials that met inclusion criteria, 87.4% (215) reported racial data. Compared to census data, Black/African American, American Indian/Alaskan Native, and 2 or more races were underrepresented. Hispanic or Latinos were an underrepresented ethnic group.Limitations: The search was limited to ClinicalTrials.gov registered studies that fell within search parameters. Race reporting methods were not specified. Detailed analysis was only performed for the most underrepresented racial group.Conclusion: Certain minority groups were underrepresented in dermatology trials. Black/African Americans were most underrepresented and underrepresented even when accounting for prevalence rates. Trial representation that accurately reflects population demographics and subgroup prevalence rates can help reduce health inequity, improve clinical understanding, and enhance treatment access for the growing diverse population. ( J Am Acad Dermatol 2023;89:293-300.)