Psoriatic Arthritis‘s Historical Perception as a “Caucasian” Disease and its Impact on Research
Psoriatic arthritis (PsA) has long been associated with White individuals, leading to significant gaps in both clinical understanding and research efforts regarding racial and ethnic disparities. Often, conditions like psoriasis and PsA are predominantly viewed as diseases affecting White populations. This perception has resulted in non-White patients being overlooked, with many facing delays or misdiagnoses, particularly when the manifestation of psoriasis differs across skin tones.
“Clinically, psoriasis can appear differently on various skin tones, leading to misdiagnoses or undiagnosed cases,” explained Dr. April Armstrong. “When psoriasis isn’t immediately recognized, rheumatologists may not consider PsA as a potential diagnosis, even in cases where it exists.”
This bias is also reflected in clinical trials, where participants are predominantly White. Research studies often show that over 90%, and sometimes more than 95%, of participants are from White backgrounds. This lack of diversity fails to mirror the true prevalence of PsA and psoriasis across all racial groups, as national surveys show a more diverse distribution. According to Dr. Armstrong’s analysis of National Health and Nutrition Examination Survey (NHANES) data, while psoriasis affects 3.6% of White individuals, it also affects 2.5% of Asians, 1.9% of Hispanics, and 1.5% of Black individuals.
The Need for Research on Racial and Ethnic Disparities in Psoriatic Arthritis
The underrepresentation of racial and ethnic diversity in PsA research prompted Dr. Armstrong and her team to investigate these disparities more closely. While much of the existing literature centers on skin psoriasis, research on PsA remains limited, with only a handful of studies examining the condition across different racial and ethnic groups.
Dr. Armstrong and her colleagues recognized a significant opportunity to address this gap, particularly due to the unique patient population they serve in New York City. “New York offers a rich blend of ethnic, racial, and socioeconomic diversity,” Dr. Armstrong noted. “The patients at Bellevue Hospital, a major public hospital, and our private practices present a distinctive demographic that isn’t often represented in current research.”
Given this diversity, Dr. Armstrong and her team are in an ideal position to contribute valuable insights into PsA research that could better reflect the experiences of non-White patients and inform treatment approaches worldwide.
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