INTRODUCTION
Hidradenitis suppurativa (HS) is a chronic skin disease characterized by debilitating symptoms associated with the highest comorbidity burden and lowest quality of life among dermatologic conditions.1 HS largely affects the African American (AA)/Black population, with epidemiology studies demonstrating the highest prevalence in Black populations.2 In the United States (US), Black patients with HS have been shown to have a higher disease burden, manifesting as higher disease severity, healthcare utilization, and number of surgeries compared to other racial groups.3 Despite this, there are notable disparities in the enrollment of Black participants in HS clinical trials. A study by Okeke et al. analyzing demographics of HS trials from 2008 to 2020 found that Black participants made up a minority (14.9%) of the participants.4 Since 2020, significant therapeutic advancements, notably FDA approvals of secukinumab, an interleukin-17A (IL-17A) inhibitor, and bimekizumab, a monoclonal antibody targeting IL-17A and IL-17F, have emerged.5,6 This study updates the current literature on Black patient representation in HS clinical trials with the advent of multiple biologic therapies and explores possible barriers to inclusion.
MATERIALS AND METHODS
A search for "hidradenitis suppurativa" was conducted on ClinicalTrials.gov for clinical trials with a start date between June 1, 2020, and December 1, 2024. Trials were included if they reported at least one of the following: race, ethnicity, or Fitzpatrick skin type (FST), and if they had at least one US location. In total, 5 trials were included. Trials were excluded if they lacked sufficient demographic data or if they were ongoing.
Patient characteristics (sex, race, ethnicity, Hurley stage) and trial characteristics (intervention type, phase, location) were collected from each trial. Data was retrieved using both ClinicalTrials.gov and PubMed by utilizing the NCT number, trial title, or authors' names to locate the corresponding articles. Black population densities at trial sites were categorized as "very low" (0.0-0.9% of population), "low" (1-12.5%), "moderate" (12.6-49.9%), or "high" (>50%) as defined by Okeke et al.4 Race categories
Patient characteristics (sex, race, ethnicity, Hurley stage) and trial characteristics (intervention type, phase, location) were collected from each trial. Data was retrieved using both ClinicalTrials.gov and PubMed by utilizing the NCT number, trial title, or authors' names to locate the corresponding articles. Black population densities at trial sites were categorized as "very low" (0.0-0.9% of population), "low" (1-12.5%), "moderate" (12.6-49.9%), or "high" (>50%) as defined by Okeke et al.4 Race categories
