Racial and Ethnic Equity in Pulmonary Arterial Hypertension Clinical Trials

Over the last several decades, many new therapies have been developed for patients with pulmonary arterial hypertension (PAH). These therapies have led to meaningful improvements in patient outcomes. Despite these advances, little is known about disparities in PAH care and even less is known about equity in clinical trial inclusion. Lack of equitable representation in PAH clinical trials may impact our understanding of risks and benefits in specific populations and may limit uptake of new therapies in minoritized populations. In this review, we begin to explore the racial and ethnic breakdown of patients receiving care for PAH and among participants who take part in clinic trials. We suggest that we have not yet achieved our goal of equitable representation in clinical trials and finish with a discussion of potential barriers and pathways forward. It is likely that progress will depend on addressing a complex interplay of patient-facing and system-derived barriers to participation.