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Others have followed this trend by publicly delaying completion of enrollment in their trial until benchmarks for representativeness are met ( 5, 6). and slowed enrollment to ensure adequate representation. Taking a sense of responsibility for racial and ethnic representativeness to a new level, one recent trial of a vaccine for SARS-CoV-2 by a U.S.-based company set targets for the enrollment of participants from specific racial and ethnic groups in the U.S. Quotas, or enrollment number targets, are one approach that may be taken to increase the number of people of color in MS clinical trials. Increasing scrutiny of the representativeness of people of color is therefore rightly gathering new attention by patients, investigators, and the general public as the science of MS rapidly advances. Many stakeholders are beginning to re-examine who enters and leads clinical trials. Although clinical trials in MS have often been considered separate from broader social, cultural, and political trends, demands for equity in all aspects of American society are rightly becoming a tour de force. MS research is highly sensitive to the many structural inequities experienced across the U.S.A.

Clinical trials for people living with MS are no exception to this reality ( 3, 4).Ĭurrent efforts to advance health equity via phase III clinical trials in MS appear inadequate. census) and just 1% are Hispanic/LatinX (compared to 18% of the U.S.

Just 5% of trial participants are African American or Black in the USA (compared to 13% of the population in the last reported U.S. Meanwhile, efforts to improve racial and ethnic diversity in clinical trials in general in the United States have largely failed ( 1, 2). Phase III trials of DMTs are usually multi-centered, spanning many countries, and involve dozens of centers and hundreds of investigators. In multiple sclerosis (MS), the number of disease modifying therapies (DMTs) continues to expand with the number of clinical trials growing rapidly, especially over the past two decades. Clinical trials form the bedrock of evidence upon which clinical decision making is based.

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