Equitable Representation in Rheumatoid Arthritis Biologic Therapy Trials

Rheumatoid arthritis (RA) is a prevalent autoimmune disease worldwide. Since the first biologic therapy for RA was approved in 1998, numerous clinical trials have been conducted on biologics (e.g., anti-TNF agents, interleukin inhibitors). However, the representativeness of these trials remains questionable. Strait, et al (1), reported on the limited representation of racial and ethnic minority groups and older age groups in RA RCT conducted in the US. To our knowledge, there is no existing systematic review analysing the equity of RCTs on biological drugs for RA patients using the PROGRESS-PLUS framework and measuring the representation of patients from low- and middle-income countries (LMICs). Our review aims to shed light on representation from LMICs. We hypothesise that patients from LMICs are underrepresented in biologic DMARDs clinical trials, and that patients from minority groups are underrepresented in those clinical trials too. 1. Strait A, Castillo F, Choden S, Li J, Whitaker E, Falasinnu T, et al. Demographic Characteristics of Participants in Rheumatoid Arthritis Randomized Clinical Trials: A Systematic Review. JAMA Network Open. 2019;2(11):e1914745–e.