Latest news with #racialDisparities
Medscape
13-06-2025
- Health
- Medscape
Diversity Gap Persists in Key Trials for Psoriatic Arthritis
An analysis of 29 pivotal drug trials for psoriatic arthritis revealed significant racial disparities, with White individuals making up the majority of trial participants, whereas Asian, Black, and other racial groups remained underrepresented. Geographic disparities in participant inclusion were also observed, with trial sites primarily located in North America and Europe. METHODOLOGY: Researchers conducted a descriptive epidemiologic study to assess the gaps in reporting of racial, ethnic, and geographic data of participants enrolled in pivotal US clinical trials of biologic and targeted synthetic disease-modifying antirheumatic drugs for psoriatic arthritis. They collected data on 14,845 participants enrolled in 29 trials with start dates from April 2000 to April 2019, using three primary public sources: Journal publications, the Drugs@FDA database, and Overall, 16 drugs with varying mechanisms were assessed in these trials: Seven trials each of TNF inhibitors and interleukin 17A or 17A/F inhibitors, four trials each of JAK inhibitors and interleukin 23 inhibitors, three trials of phosphodiesterase 4 inhibitors, and two trials each of cytotoxic T-lymphocyte antigen immunoglobulin and interleukin 12/23 inhibitors. TAKEAWAY: Data on race were reported in 93% of trials, with the most frequent reporting in journal publications (86%), although 46% of them reported the proportion of only White participants. Among participants for whom data on race were available, 92% were White, 5% were Asian, 0.6% were Black, 0.3% were American Indian/Alaska Native, and 0.1% were Native Hawaiian/Pacific Islander individuals. Ethnicity was formally reported in only 41% of trials. The reporting of both race and ethnicity improved over time, reaching full coverage (eight of eight trials) on between 2016 and 2020. Among participants for whom data on ethnicity were available, 11% were Hispanic or Latino individuals. Within the US, the highest participation was reported from Texas (24 trials), Florida and Pennsylvania (22 each), California (20), and Alabama (18), with participation in clinical trials strongly correlated with state population size (correlation coefficient, 0.78; P < .0001). Trial sites were primarily located in North America and Europe, with limited representation in Asia, Africa, and Latin America. IN PRACTICE: 'Standardizing and mandating race and ethnicity reporting across data sources is crucial to ensure transparency and equity. Tailored and multifaceted recruitment strategies are essential to increase diversity and ensure the generalizability of trial results, ultimately aiding clinicians to provide the most effective and informed treatment options for all patients,' the authors wrote. SOURCE: This study was led by Mathieu Choufani, MD, Brigham and Women's Hospital, Boston. It was published online on May 19, 2025, in Arthritis Care & Research . LIMITATIONS: This study relied on the US-centric Office of Management and Budget categories for data on race and ethnicity, which may not have represented international populations. Definitions of categories were inconsistent across data sources. Site-level enrollment details were lacking. The analysis was focused solely on pivotal trials for FDA-approved drugs. DISCLOSURES: This study had no specific outside funding source. One author reported receiving consulting fees and grants from various pharmaceutical organizations and being a member of the board of directors for the Spondyloarthritis Research and Treatment Network. Another author reported owning stocks in UCB and Abcuro.
Bloomberg
02-06-2025
- Business
- Bloomberg
South Africa's Black Empowerment Laws and the Long Shadow of Apartheid
During the eras of colonialism and apartheid, Black South Africans were subjugated, denied a decent education, and excluded from the mainstream economy. Severe racial disparities endure to this day, more than three decades after the end of White-minority rule. South Africa ranks as one of the world's most unequal countries, according to analysis by the World Inequality Lab. The government has introduced a series of policies to try to narrow the wealth gap. While these Black-economic-empowerment measures have helped diversify corporate ownership and grow a Black middle class, critics say a small, politically connected elite have been the primary beneficiaries.
Medscape
07-05-2025
- Health
- Medscape
Uterine Cancer Survival Varies Widely by Race Across US
A study of 162,500 patients with uterine cancer found that survival rates varied significantly by race and geographic location, with Black patients experiencing the worst survival outcomes in areas with high and low overall diversity. METHODOLOGY: Despite known racial and ethnic disparities in uterine cancer survival in the United States, data on the association between geographic region and these disparities remain limited. A retrospective cohort study analyzed outcomes from 162,500 patients with uterine cancer (median age, 61 years at diagnosis) between 2000 and 2019 from 17 Surveillance, Epidemiology, and End Results (SEER) registries. Researchers categorized patients by race and ethnicity: 7.5% were Asian individuals, 8.6% were Black individuals, 12.8% were Hispanic individuals, and 71.1% were White individuals. Geographic locations were ranked from 0% to 100% by the US Census Bureau's Diversity Index, with higher values indicating greater diversity. Values varied from 76.0% for Hawaii to 30.8% for Iowa. The primary outcome was uterine cancer–specific survival. The median follow-up durations were 84 months for Asian patients, 59 months for Black patients, 73 months for Hispanic patients, and 93 months for White patients. TAKEAWAY: Compared with White patients, Asian patients had better cancer-specific survival (hazard ratio [HR], 0.91), whereas Black patients had worse cancer-specific survival (HR, 1.34), and cancer-specific survival for Hispanic patients was similar (HR, 1.01; 95% CI, 0.97-1.06 ). Black patients experienced worse survival than White patients in both high-diversity areas (HR, 1.34 in California and New Jersey; HR, 1.39 in Georgia) and low-diversity locations (HR, 1.34 in Louisiana; HR, 1.42 in Connecticut; HR, 1.71 in Iowa). Compared with White patients, Hispanic patients showed worse survival in Hawaii (HR, 2.09) and Georgia (HR, 1.44), whereas Asian patients demonstrated better survival in California (HR, 0.91). Black patients with low-grade endometrioid, nonendometrioid, and early-stage disease had worse survival in Louisiana than White patients (HRs 2.08, 1.29, and 1.77, respectively), and those with high-grade endometrioid disease in Seattle and nonendometrioid disease in Iowa also had worse outcomes (HRs, 2.23 and 2.01, respectively). IN PRACTICE: 'In this cohort study of patients with uterine cancer, racially and ethnically disparate uterine cancer–specific survival was observed in specific geographic locations,' the authors wrote. 'While etiologic studies that assess the causes of geographically defined racially and ethnically disparate uterine cancer survival are needed, our findings suggest that locations with the most pronounced racial and ethnic disparities should be prioritized.' SOURCE: The study, led by Caitlin E. Meade, Division of Epidemiology, College of Public Health, Ohio State University in Columbus, Ohio, was published online in JAMA Network Open . LIMITATIONS: The analysis focused was limited to 11 locations with SEER registries. The researchers noted that the low power in areas with lower diversity indices might have affected the detection of racial and ethnic disparities. The study also lacked other measures of structural inequities and systemic discrimination that could contextualize the findings. DISCLOSURES: The study received grants from the National Cancer Institute. Several authors reported receiving personal fees or grants from various sources.
