Assessing Ethnic Minority Representation in Fibromyalgia Clinical Trials: A Systematic Review of Recruitment Demographics

Abstract

The under-representation of non-White participants in Western countries in clinical research has received increased attention, due to recognized physiological differences between ethnic groups, which may affect the efficacy and optimal dosage of some treatments. This review assessed ethnic diversity in pharmaceutical trials for fibromyalgia, a poorly understood chronic pain disorder. We also investigated longitudinal change to non-White participant proportions in trials and non-White participants’ likelihood to discontinue with fibromyalgia research between trial stages (retention). First, we identified relevant trials conducted in the United States and Canada between 2000 and 2022, by searching PubMed, Web of Science, Scopus, and the Cochrane Library databases. In trials conducted both across the United States and Canada, and exclusively within the United States, approximately 90% of participants were White. A longitudinal analysis also found no change in the proportion of non-White participants in trials conducted across the United States and Canada between 2000 and 2022. Finally, we found no significant differences in trial retention between White and non-White participants. This review highlights the low numbers of ethnic minorities in fibromyalgia trials conducted in the United States and Canada, with no change to these proportions over the past 22 years. Furthermore, non-White participants were not more likely to discontinue with the fibromyalgia research once they were recruited.

Anti-inflammatory Role of Trypsin, Rutoside, and Bromelain Combination in Temporomandibular Joint Osteoarthritis: A Systematic Review

“…These symptoms are akin to those observed in patients with chronic pain syndromes affecting other body parts, including chronic headache, chronic regional pain syndrome, arthritis, low back pain, and fibromyalgia. Consequently, a comprehensive diagnostic approach and treatment strategy are essential for managing such cases [15][16][17].…”

“…in connection with the immunological system as a defensive mechanism. In doing so, the body endeavors to safeguard its long-term health [16,17]. Proteolytic enzymes such as pancreatin, papain, rutin, trypsin, and chymotrypsin are crucial regulators and inflammatory response modulators.…”

“…Trypsin is known to exhibit antioxidative effects, and it can influence the activation of protease-activated receptor 2. This action has been associated with a reduction in the inflammatory reaction [17]. Rutoside trihydrate has been reported to have antiinflammatory properties, and it is suggested that it can inhibit the production of pro-inflammatory genes in human macrophages [10].…”