Updates in Clinical Study of Patients of Color

Mona Shahriari, MD, FAAD, an assistant clinical professor of dermatology at Yale University and associate director of clinical trials at CCD Research, addressed several critical issues in dermatology at the 2025 MOPD conference in Miami Beach. Her insights focused on enhancing patient trust, improving diversity in clinical trials, and addressing disparities in clinical imagery for diverse skin types.

One of the key challenges in dermatologic clinical trials is the lack of trust between clinicians and patients, particularly among individuals from diverse backgrounds. Shahriari emphasized that many patients from these communities have historical reasons for their skepticism, as they were often the subjects of unethical medical practices. Because of this, she advocates for offering clinical trial participation as an option rather than pushing patients into it, allowing trust to build over time.

“A big part of why we have challenges in achieving clinical diversity is that lack of trust between the clinicians as well as the patients,” Shahriari said. “I can’t tell you how many patients come to me because they tell me, 'You look like me, so you must know how to help me.'”

In regard to drug efficacy across different ethnicities, Shahriari noted that there is insufficient data to draw definitive conclusions. She pointed out that many dermatology clinical trials suffer from the underrepresentation of patients from diverse backgrounds, which hampers our understanding of how treatments can perform across ethnicities. She cited a study on secukinumab, which showed lower efficacy in Asian populations and higher adverse events compared to white patients, suggesting a possible difference in drug metabolism.

“That’s why a big push toward having more inclusive clinical trial design… will help us answer those questions,” Shahriari noted.

Shahriari also highlighted efforts to improve clinical imagery for patients with skin of color. During her residency and beyond, she noticed that most textbooks, advertisements, and online dermatology resources featured images of white skin, which posed challenges for diagnosing conditions in diverse populations. She praised initiatives like a trial from Johnson & Johnson, which developed a library of 20,000 images of plaque psoriasis across diverse skin tones, and expressed a desire for similar resources in other dermatologic conditions.

To address the underrepresentation of diverse populations in dermatologic research, Shahriari pointed to ongoing initiatives aimed at making clinical trials more inclusive. She discussed a draft guidance from the FDA aimed at improving eligibility criteria and accommodating patients with transportation or other barriers. However, Shahriari stressed that achieving true diversity in clinical trials is not a simple matter of setting quotas, noting that a comprehensive approach is necessary as the journey toward inclusivity continues.

Dermatology Times staff are onsite at the Loews Miami Beach Hotel for MOPD and SBS 2025. Subscribe to our eNewsletter for the latest in expert insights, exclusive interviews, and late-breaking data.

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