How Can We Make Psoriasis Research More Equitable?

Announcer:
This is DermConsult on ReachMD. On this episode, we’ll hear from Dr. Megan Hauptman, who will be discussing future research priorities for psoriasis patients with skin of color. Dr. Hauptman is a Clinical Research Fellow in the Program for Clinical Research in Dermatology at the University of Michigan Medical School in Ann Arbor.

Let’s hear from her now.

Dr. Hauptman:
Future research and clinical trials really should prioritize diverse participant recruitment and culturally competent study design, and specifically investigate outcomes specific to darker skin tones in research for psoriasis in patients with skin of color.

There's a recently published VISIBLE trial by Alexis et al. in JAMA Dermatology, and it provides a comprehensive framework for addressing these needs through several key innovations. The first being diverse participant recruitment. Researchers need to be intentional in where to geographically conduct the study, and really consider the demographics of the area and emphasize serving populations with skin of color. And by having study materials and patient-reported outcomes translated into participants' primary language and flexible eligibility criteria that accounted for diagnostic delays common in this population, it enabled the VISIBLE trial to enroll approximately seven times faster than anticipated, with 100 percent of participants self-identifying as non-white and more than 50 percent having Fitzpatrick skin types four to six.

The second is culturally competent study design. We should be using objective skin tone measurements rather than relying on self-reported Fitzpatrick skin types, and also utilizing multiple pathways for psoriasis diagnosis validation—including, say, clinical diagnosis more than six months, positive biopsy, an expert panel to confirm photographs, and collection of both standard and cross-polarized clinical photographs, to help better visualize erythema and differentiate it from hyperpigmentation.

The third is investigating outcomes specific to darker skin tones. Research priorities specific to skin-of-color patients should assess the natural history and treatment impact of post-inflammatory pigment alteration using combined photography and validated patient-reported measures.

The last is that infrastructure requirements should establish partnerships with community-based organizations, ensuring diverse representation, blinded central review on efficacy scoring to promote consistency across skin tones, and providing onsite translation services.

So we really feel that, by incorporating all these points, we can better serve patients with skin of color living with psoriasis.

Announcer:
That was Dr. Megan Hauptman talking about how we can improve the research of psoriasis in patients with skin of color. To access this and other episodes in our series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!