Equity in Asthma Research: A Meta-Analysis on Participant Diversity in U.S. Clinical Trials

The increasing diagnosis of asthma in the United States has disproportionately affected historically marginalized groups, leading to higher healthcare costs and more missed days due to illness. Despite ongoing improvements, there is a significant gap in comprehensive diversity analyses within current clinical trials for asthma.

To assess the degree of relevant demographic reporting in current clinical trials concerning asthma.

We performed a systematic review and meta-analysis on the reported sex, age, and race/ethnicity of participants in all asthma-related clinical trials in the U.S. published from January 1, 2018 to December 31, 2023. We extracted all clinical trials for sex, age, and race. A participation-to-disease representation ratio (PDRR) was determined for each demographic and qualitative assessment was determined from the summation of the score.

Of the initial 1757 search returns, 116 were eligible for full-screen extraction based on our criteria. In regard to sex, 39 trials (39/116, 33.6%) have an overall representation rating of Good. Only 1 trial (1/116, 0.8%) was given a rating of Good for overall race/ethnicity representation. Age group data was rarely reported, with only 2 trials (2/116, 1.7%) reporting inclusion of older adults.

While current U.S.-based asthma clinical trials are making noticeable progress in sex/gender inclusivity, there are still significant shortcomings in the inclusion and reporting of non-white racial and ethnic groups. It is imperative that future asthma clinical trials address this limitation to ensure equitable treatment for all populations.