Racial and ethnic representation in clinical trials of janus kinase inhibitors for dermatologic conditions: A systematic review

Summary: <br /> Janus kinase (JAK) inhibitors represent promising therapies for various dermatologic conditions, and adequate racial representation in clinical trials is essential to ensure generalizability. We conducted a systematic review of published JAK inhibitor clinical trial results for dermatologic indications and evaluated demographic representation. Trials were identified via PubMed and ClinicalTrials.gov. Studies from 2000 to 2025 were included. Animal studies, review papers, and duplicated studies were excluded. Of 401 identified studies, 206 clinical trials were included for review. 57,112 study participants were evaluated. Among studies reporting race (57.5%), representation was predominantly White (75.1%), followed by Asian (13.2%), Black (6.6%), American Indian/Alaska Native (0.48%), Native Hawaiian (0.11%), and Multiple races (0.43%). White participant representation closely aligned with their U.S. population proportion (75.3%), while Asian participants were overrepresented (13.2% vs. 6.4%), and Black participants were underrepresented (6.6% vs. 13.7%). Underrepresentation was pronounced among Black participants in psoriasis (1.3%), SLE (1.0%), and vitiligo trials (5.1%), although higher in HS (27.9%). Differences in racial representation in trials across conditions differed significantly from the U.S population (p=0.021). Representation in these trials significantly differed from the racial distribution of U.S. patients with vitiligo (p = 0.012) and AD (p = 0.00088). White patients were overrepresented in vitiligo and AD trials (Pearson's residual=2.71, 0.99), and Black patients were underrepresented in vitiligo and AD trials (Pearson's residual=-2.41, -1.84). These findings highlight a critical need for improved recruitment strategies targeting underrepresented populations to enhance the inclusivity and applicability of dermatologic clinical research. Christine T. Olagun-Samuel², Maame-Afua Ansah¹, Purvi Shakelly¹, Nabiha Sherali¹, Aminat Ologunebi³, Prince Adotama² 1. Rutgers New Jersey Medical School, Newark, NJ, United States. 2. Dermatology, New York University Grossman School of Medicine, New York, NY, United States. 3. American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten (Dutch part). Minoritized Populations and Health Disparities Research