Real world data reveal how diseases manifest in diverse populations

The prevalence and co-occurrence of immune-mediated inflammatory diseases (IMIDs) like inflammatory bowel disease and rheumatoid arthritis varies by race and ethnicity among U.S. adults.

That's the upshot of a retrospective cohort study of 10.8 million U.S. adults performed by Clarivate researchers using claims and electronic health record data, data often referred to as real-world data (RWD). The nuances of these variations are important because these diseases are often misdiagnosed, and diseases are more broadly underdiagnosed among racial and ethnic minorities in the U.S. Greater awareness among clinicians could improve early diagnosis and disease management in patients.

"Autoimmune diseases are generally difficult to diagnose, with misdiagnoses often frequent, and race and ethnicity data a persistent gap in the autoimmune disease research literature," said Evelyn P. Davila, PhD, Senior Director, Epidemiology at Clarivate. "These conditions have mostly been studied in non-Hispanic White and Black individuals in the US, with few studies conducted on individuals of Hispanic ethnicity and other race/ethnicities. This lack of research can potentially increase the likelihood of misdiagnoses in these less studied racial and ethnic groups."

That's a problem for patients, in whom treatment safety and efficacy can sometimes vary by ethnicity, as well as developers, who are under increasing pressure from regulators like FDA to demonstrate how their products stand to impact diverse populations. Fortunately, RWD is beginning to offer a means of augmenting clinical trials, which can't always furnish robust sample sizes for subpopulations.

"Our ability to conduct several statistical regression analyses," said Dr. Davila, "is facilitated by the large sample size available through electronic medical records and claims data, surpassing the limitations of smaller datasets typical in more traditional observational or clinical studies. Leveraging real world data (RWD) not only enables more precise estimations but also allows a comprehensive analysis of a wide range of autoimmune diseases, thanks to the richness and depth of information."

In the Clarivate study, researchers found that while differences in prevalence between racial and ethnic groups showed only modest variability, differences in comorbidity were substantial. For example, while the most frequently co-occuring immune-mediated inflammatory diseases among non-Hispanic Whites were inflammatory bowel disease (IBD) and psoriasis/psoriatic arthritis (Pso/PsA), for non-Hispanic Black, Hispanic and Asian adults, it was systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

"Because misdiagnoses are relatively frequent for patients with IMIDs, awareness of racial and ethnic variations in IMIDs could aid early diagnosis and improve disease management," the paper concluded.

"Our collaboration with multiple pharmaceutical firms has highlighted the significance of comprehending diverse population groups afflicted by various medical conditions," said Dr. Davila. "This involves analyzing demographics and probing into the risk factors linked to specific diseases or conditions. Such insights aid in gauging the market demand for newly developed medications. Regulatory bodies like the FDA are increasingly mandating thorough demographic assessments to address potential sampling biases, enhance research applicability, and mitigate inequities in diagnosis and treatment. That's why, via our Insights Platform, we provide comprehensive epidemiological reports offering incidence and prevalence estimates for over 220 diseases, segmented by age and gender. Subscribers gain access to this invaluable data, and should they require race and ethnicity insights, they can easily request a tailored analysis for any disease they're focusing on."

Clarivate's suite of epidemiology data helps life science companies size and understand target markets, with coverage of over 220 diseases and biomarkers across 45 countries and 3.500-plus patient segments. To learn more, please visit us here. You can read about the study here.