• Underscores the urgent need for improved diagnosis and clinical management of psoriasis in patients with skin of colour and enhanced treatment standards

TORONTO, Jan. 23, 2025 /CNW/ - Johnson & Johnson (NYSE: JNJ) is proud to announce a Canadian first: the publication of a consensus statement titled, "Optimizing the management of psoriasis in patients with skin of colour: a Canadian Delphi consensus." This groundbreaking consensus underscores the urgent need for improved diagnosis and clinical management of psoriasis in patients with skin of colour, offering expert recommendations to address the gaps in care for this patient population.

Johnson & Johnson maintains an ongoing commitment to advancing inclusive clinical research and addressing health inequities. This commitment and the recognition of significant gaps in the treatment of psoriasis in patients with skin of colour contributed to the momentum toward this consensus.ⁱ Limitations in the available evidence and research have contributed to disparities in care, leaving many of these patients underserved.ⁱ By validating these challenges through rigorous study, Johnson & Johnson is proud to support the development of this consensus by 16 Canadian dermatologists from diverse geographic and ethnic backgrounds. This consensus will help bridge the existing gaps in care for patients with skin of colour and psoriasis.

"The development of the Canadian consensus statements on psoriasis in skin of colour represents a pivotal moment in dermatology. As a dermatologist specializing in skin of colour, I have witnessed first-hand the gaps in care and the critical need for tailored diagnostic and treatment approaches," said Dr. Geeta Yadav, M.D., FRCPC, dermatologist, investigator for the VISIBLE study, and core faculty member for the Canadian consensus. "The consensus paper is a transformative step toward addressing these disparities in clinical research and real-world clinical management.ⁱⁱ By enhancing our understanding and improving clinical guidelines, we can ensure that all patients receive the precise, effective care they need."

The skin of colour consensus was developed using a modified Delphi methodology, a structured process for achieving agreement among experts. The expert consensus panel included 16 Canadian dermatologists including four core faculty members who guided the content development, while 12 additional panel members contributed by reviewing, voting, and refining the consensus statements. This collaborative effort resulted in a total of 24 consensus statements: 11 statements on terminology related to skin of colour, five primary and four secondary statements addressing clinical presentation and differential diagnosis, as well as guiding principles for treatment grounded in both evidence and expert opinion. Four more statements focused on current assessment tools and access to care, which were based solely on expert insights.

"These consensus statements are not just a guideline but a tool to reshape how we educate and train future dermatologists," said Dr. Jensen Yeung, M.D., FRCPC, Director of Psoriasis Clinic at Women's College Hospital and Associate Professor, Department of Medicine, University of Toronto and core faculty member for the Canadian consensus. "By incorporating insights from diverse experts, we are equipping healthcare providers with the knowledge and resources needed to recognize the unique presentations of psoriasis and the distinct responses to treatment in people with skin of colour. This collaborative effort is a crucial step in building a more inclusive and effective standard of care that extends beyond just the research setting and into everyday clinical practice to optimize patient outcomes."

Key recommendations from the Canadian consensus include:

1. Culturally Sensitive Care: Canada's increasing diversity underscores the need for culturally competent care. Canada's racialized population is projected to account for 41 per cent of the country's total population by 2041.ⁱⁱⁱ As Canada's population becomes more diverse, dermatologists must adopt inclusive, descriptive language that accurately reflects the full spectrum of skin tones. Psoriasis can present differently in people with skin of colour, making it crucial to develop a vocabulary that supports accurate diagnosis and treatment.^iv The consensus states that the concept of "race" has no scientific justification, and that racial, ethnic and geographical terms are unrelated to skin traits, further recommending that dermatologists should remain focused on biological traits of skin, using descriptive terms reflecting cutaneous diversity to tailor care to all patients, inclusive of all skin tones.
   
   
2. Clinical Presentation and Differential Diagnosis: Psoriasis in skin of colour can appear as purple, grey, or hyperpigmented patches rather than the classic red and scaly plaques seen in lighter skin.^iv These variations can lead to underdiagnosis or misdiagnosis, delaying appropriate care. Studies show that only 4-19% of images in dermatology textbooks feature conditions on darker skin tones, contributing to these diagnostic challenges.^v The consensus states that special considerations are needed when assessing psoriasis in people with skin of colour due to differences in its clinical presentation. The statement emphasizes the need to develop comprehensive databases of images of skin colour, to reflect the diversity of people and disease presentations.
   
   
3. Representation and Educational Gaps: People with skin of colour have historically been underrepresented in clinical trials and dermatology education.^vi Globally, only 14.2% of participants in psoriasis clinical trials are non-white, limiting the understanding of treatments' efficacy in diverse populations.^vi The lack of representation in medical literature and research creates gaps in both diagnosis and treatment, as healthcare providers may not be familiar with psoriasis' manifestation in different skin tones.^i,vi The consensus highlights the importance of promoting education to, and the utilization of skin-of-colour concepts with, educators, researchers, healthcare providers, and the general public, further calling for more equitable representations in future clinical trials and studies.
   
   
4. Psychological and Emotional Impact: Psoriasis affects over one million Canadians, including an estimated 250,000 Canadians with skin of colour who are living with the condition.^i,vii,viii Psoriasis is linked to significant mental health challenges, including a higher risk of depression, anxiety, and suicidal behaviours.^ix Studies show that over a third of people with psoriasis report a significant impact on their daily lives due to the physical and emotional burden of the disease.ⁱ For people with skin of colour, barriers such as delayed diagnosis, misdiagnosis, and limited access to culturally sensitive care exacerbate these mental health challenges.^ix The consensus states that pigmentary alteration disproportionately impacts people with skin of colour and may negatively affect their quality of life, further emphasizing the need for holistic care that considers both the physical and psychological impacts of psoriasis.

"This landmark consensus paper represents a significant advancement in the care of psoriasis in patients with skin of colour by providing a much-needed framework for addressing the disparities in diagnosis and treatment that have long affected this patient population," said Antonella Scali, Chief Executive Officer,  Psoriasis Canada. "These statements will make a profound difference in improving quality of life for patients by fostering more inclusive and effective treatment approaches. We urge healthcare professionals and stakeholders to embrace and implement these guidelines to bridge the existing gaps in psoriasis care."

Johnson & Johnson has a longstanding tradition of innovation in dermatology and dedication to enhancing patient care, spanning over 17 years of continuous research and development, and a vested interest in advancing diversity, equity and inclusion (DEI) in dermatology. To foster more inclusive and equitable clinical research, Johnson & Johnson also supported the initiation of VISIBLE, the first study in psoriasis research history to inclusively enroll patients from all skin tones and objectively measure clinical outcomes across diverse groups.^x Conducted in both the U.S. and Canada, the VISIBLE study addressed the under-representation of diverse patient populations in clinical research.^xi

"The publication of the Canadian consensus statements on optimizing the management of psoriasis in people with skin of colour marks a transformative step in dermatology, setting a new standard for the care of psoriasis in people with skin of color. This landmark work reflects Johnson & Johnson's proud legacy of over 17 years of innovation in dermatology and our strong commitment to addressing healthcare disparities through inclusive research," said Berkeley Vincent, President, Johnson & Johnson Innovative Medicine, Canada. "By incorporating these consensus statements into clinical practice, we can pave the way for more equitable treatment and better patient outcomes. Johnson & Johnson remains dedicated to advancing diversity, equity, and inclusion (DEI) while leading with purpose to foster excellence in patient care and create a more equitable healthcare landscape for all."

For more information, please refer to the full publication in the Journal of the American Academy of Dermatology International.

About Psoriasis

Psoriasis is an immune-mediated disease resulting in an overproduction of skin cells, which causes raised, red, scaly plaques that may be itchy or painful.^xii It is estimated that more than 1 million Canadians and more than 125 million people worldwide live with the disease.^xiii Nearly one-quarter of all people with psoriasis have cases that are considered moderate to severe.^xiv Living with psoriasis can be a challenge and impact life beyond a person's physical health, including emotional health, relationships, and handling the stressors of life.^xv

Data on the clinical presentation of PsO amongst people of color are scarce, and there have been no large-scale prospective studies to date that evaluate the use of biologics exclusively in patients from diverse racial and ethnic backgrounds.^xvi People with skin of colour often are misdiagnosed or experience a delay in diagnosis, and they are less likely to receive treatment with more advanced and effective therapies, which can have negative effects on their physical health and quality of life.^xvii

About VISIBLE^xviii

VISIBLE is a Phase 3b multicenter, randomized, double-blind, placebo-controlled study examining the efficacy and safety of guselkumab administered by subcutaneous injection in participants with moderate to severe plaque PsO and/or moderate to severe scalp PsO who self-identify as non-white. The study will evaluate approximately 200 participants from the U.S. and Canada who will be treated and followed for approximately two years.

About Johnson & Johnson

At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Janssen Inc. is a Johnson & Johnson company.

Learn more at innovativemedicine.jnj.com/canada. Follow us on LinkedIn at Johnson & Johnson Innovative Medicine, Canada and X at @JNJInnovMedCAN.

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