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Racial minorities are under-represented in SLE clinical trials: A systematic review and meta-analysis
Matthew A Turk1, Jordan Hausman2, Janet E Pope3
1Division of General Internal Medicine, Dept of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Autoimmunity Reviews
|May 26, 2026
Summary
Recent systemic lupus erythematosus (SLE) clinical trials under-represent racial and ethnic minorities, especially Black participants. Ensuring diverse representation in SLE randomized controlled trials (RCTs) is crucial for generalizability and equity.
Area of Science:
- Rheumatology
- Clinical Trials
- Health Equity
Background:
- Systemic lupus erythematosus (SLE) disproportionately affects Black populations.
- Emerging SLE treatments necessitate diverse clinical trial populations.
- Current SLE trials may not reflect the disease's epidemiological diversity.
Purpose of the Study:
- To assess the racial and ethnic composition of SLE randomized controlled trials (RCTs).
- To determine if recent SLE RCTs accurately represent diverse patient populations.
Main Methods:
- Systematic literature review of SLE RCTs from 2014-2024.
- Searched EMBASE, PubMed, Web of Science, and Cochrane CENTRAL.
- Included studies with >=50 participants, in English, reporting race/ethnicity.
Main Results:
- 63 SLE RCTs were included, with 91% female participants.
- White participants: 61%, Black: 14%, Asian: 14%, Indigenous: 8%.
- Hispanic/Latino ethnicity reported in 37%, with inconsistent reporting.
Conclusions:
- Racial and ethnic minorities, particularly Black individuals, are under-represented in SLE RCTs.
- Inconsistent race/ethnicity reporting limits interpretation.
- Increased efforts are needed for SLE trial generalizability and diversity.
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