The pace at which scientific innovation is shaping and reshaping the health – and lives – of people has been transformative. Yet, for all the progress that has been made in how the medical community diagnoses and treats diseases, challenges remain. Among them is a lack of clinical data involving people of color who may be impacted by various medical conditions and may respond differently to current and emerging therapies, compared to white patients who have traditionally been at the center of medical research. These gaps in data, coupled with historical inequities in healthcare for people of color, stand in the way of patients achieving better health outcomes.
Recognizing these inequities in care, Janssen is driven to develop medicines for unmet needs, guided by the understanding that diseases and therapies may impact people differently based on their race and ethnicity. An important area of focus for Janssen is diversity in clinical studies, one essential component of Johnson & Johnson’s Our Race to Health Equity (ORTHE) commitment. ORTHE aspires to help eradicate racial and social injustice as a public health threat by eliminating health inequities for people of color and ensuring that skin color is not a determinant of access to care, quality of care or health outcomes.
Diagnosis challenges in people of color with plaque psoriasis
The impact of these disparities is particularly felt in dermatologic conditions like plaque psoriasis. Often mischaracterized as just an uncomfortable skin condition, this chronic immune-mediated disease takes a physical, psychological, and emotional toll on the more than eight million Americans affected by it. For people of color living with this condition, underrepresentation in clinical studies has created a lack of data and, as a result, barriers to care. Plaque psoriasis may also present with less noticeable skin reddening on darker skin tones, which can make it harder for healthcare providers to identify, leading to misdiagnoses or delayed diagnoses.
“There are several factors that contribute to the challenges that people of color with plaque psoriasis face, including limited research data around patients belonging to different racial and ethnic groups, gaps in medical education and access barriers to advanced treatments,” said Andrew Alexis, M.D., M.P.H., “With more complete data, dermatologists can accurately diagnose plaque psoriasis on all skin tones and ensure their patients are receiving appropriate treatment options.”
Andrew Alexis, M.D., M.P.H., professor of clinical dermatology and vice-chair for diversity and inclusion at Weill Cornell Medicine in New York
Access to biologics and other advanced therapies
Biologic therapies reduce inflammation by targeting overactive cells in the immune system, thus improving short- and long-term symptoms in plaque psoriasis patients. For patients with moderate to severe plaque psoriasis, a biologic treatment may be recommended to help manage symptoms. However, access to advanced therapies such as biologics for people of color has historically been inadequate. One study shows Black patients are 69 percent less likely to receive biologics than white patients. While there are several factors that are hindering access to biologics, one explanation is that people of color may not feel that they have a relationship with a doctor who they trust and who understands their culture and needs – especially in the dermatology field, where Black, Latino, and Indigenous physicians are underrepresented minorities.
The road to equitable research in moderate to severe plaque psoriasis
To address these barriers, Janssen is working with leading dermatologists, like Dr. Alexis, to launch the VISIBLE study, a large-scale prospective study designed specifically to understand and characterize moderate to severe plaque psoriasis in Black, Hispanic, Asian, Indigenous and other people of color. The study will further evaluate the efficacy and safety of one of Janssen’s treatments for moderate to severe plaque psoriasis to generate additional data and provide valuable information about disease burden and the patient journey for people of color.
“We designed this study to help create a more equitable and inclusive clinical research process by taking new approaches to enrollment and retention, as well as broader community engagement, investigator training support and generating new data that are unique and relevant to people of color,” said Daphne Chan, Ph.D., Head of Dermatology Medical Affairs at Janssen Immunology. “We will also compile a collection of clinical photos across different skin tones that will help serve as educational visuals showing how psoriatic disease presents in people of color.”
The VISIBLE study is just one of many ways in which Janssen is working to set a new standard where diverse populations are fully represented in clinical studies, as the company continues its mission to relentlessly advance care. For more information or to potentially participate in the study, learn more at ClinicalTrials.gov.
© Janssen Biotech, Inc. 2022 10/22 cp-338646v1