Racial and Ethnic Representation in Clinical Trials of Janus Kinase Inhibitors for Dermatologic Conditions: A Systematic Review
April 2026 | Volume 25 | Issue 4 | 316 | Copyright © April 2026
Published online March 31, 2026
Christine Olagun-Samuel BAa*, Maame-Afua Ansah BAb*, Purvi Shakelly BSb, Nabiha Sherali BAb, Aminat Ologunebi BSc, Kristen Lo Sicco MDa, Prince Adotama MDa
aRonald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY
bRutgers New Jersey Medical School, Newark, NJ
cAmerican University of the Caribbean School of Medicine, Cupecoy, Saint Maarten
Abstract
Background: Janus kinase (JAK) inhibitors represent promising therapies for dermatologic conditions, including psoriasis, hidradenitis suppurativa (HS), atopic dermatitis (AD), systemic lupus erythematosus (SLE), and vitiligo. There are little data available evaluating the composition of research cohorts for this emerging treatment modality. Adequate racial representation in clinical trials is essential.
Objective: To characterize the study populations of clinical trials for Janus kinase inhibitors for dermatologic indications.
Methods: Clinical trials were identified from January 2000 to March 2025 through PubMed using the following keywords: "Janus kinase inhibitor," "JAK inhibitor," "alopecia areata," "atopic dermatitis," "hidradenitis suppurativa," "systemic lupus erythematosus," "systemic sclerosis," "psoriasis," and "vitiligo." Additional trials were retrieved from ClinicalTrials.gov using the search term "JAK inhibitor." Each trial was reviewed for demographic data, including race and ethnicity. Additional variables collected included Fitzpatrick skin type and quality-of-life measures. The distribution of race among trial participants was compared to the current US population and the condition-specific prevalence data where available.
Results: Of 399 identified studies, 207 clinical trials were included in our analysis, including 57,112 study participants were analyzed. 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%). Underrepresentation was pronounced among Black participants in psoriasis (1.3%), SLE (1.0%), and vitiligo trials (5.1%), although higher in HS (27.9%). Representation in these trials significantly differed from the racial distribution of US patients with vitiligo (P=0.012) and AD (P=0.00088). White patients were overrepresented in vitiligo and AD trials (Pearson residual=1.06, 2.71), while Black patients were underrepresented in these trials (Pearson residual=-2.66, -2.14). Additionally, a minority of studies (28.98%) reported on QoL metrics, which are essential tools for measuring disease burden and impact on patients.
Conclusion and Relevance: Reporting on racial data, Fitzpatrick skin type, and quality of life measures is lacking in clinical trials for Janus kinase inhibitors. These factors play a key role in addressing comorbidities and mitigating disease burden. These findings highlight a need for improved recruitment strategies targeting underrepresented populations in dermatologic clinical research.
INTRODUCTION
Increasingly, therapeutic advancements in dermatology favor targeted modalities, such as monoclonal antibodies and biologic therapies, which specifically address inflammatory cytokines, offering alternatives to broader immunosuppressive treatments.1,2 Janus kinase (JAK) inhibitors represent a more recent therapeutic innovation for dermatologic disease, with FDA approvals for alopecia areata, vitiligo, and atopic dermatitis.3,4 These agents modulate intracellular signaling through the JAK-STAT pathway, involved in inflammation and autoimmune pathogenesis, offering promising treatment options for dermatologic conditions disproportionately affecting patients of color.5
In recent years, several JAK inhibitors have received regulatory approval for dermatologic indications. Baricitinib was ap-proved by the United States Food and Drug Administration (FDA) in 2022 as the first systemic therapy for alopecia areata, representing a major advance in managing this autoimmune condition.6 Topical ruxolitinib has been approved for both
