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Gender and racial equity in clinical research for idiopathic pulmonary fibrosis: a systematic review and meta-analysis

Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial lung disease (ILD) characterised by progressive, irreversible pulmonary parenchymal fibrosis leading to substantial morbidity and shortened survival [1]. Although IPF seems to affect older men predominantly, the true prevalence of IPF in women is difficult to establish, and women may be underdiagnosed while men are overdiagnosed with IPF based on gender alone [2]. Racial and ethnic distribution of IPF has also not been well evaluated in the literature so far, although some studies suggest that non-white patients are diagnosed with IPF at a younger age, and that those of black ethnicity are less likely to receive a diagnosis of IPF [3, 4]. Broad and equitable representation and inclusion of patients with diverse race and gender in clinical research is important, especially for a disease such as IPF, where the prognosis is poor and the effective interventions are few. Equitable representation in research that matches the true distribution of disease in populations allows for improved external validity of findings, leading to increased generalisability of interventions to all patients living with IPF [5]. Racial and gender-based disparities exist in clinical studies of IPF: 14% of participants in registries or RCTs in IPF are non-white, while the pooled proportion of women in clinical trials is 22%, compared to 27% in prospective registry studies https://bit.ly/3I6DfnJ