Rocatinlimab’s OX40-targeted therapy for severe atopic dermatitis: systemic gaps in clinical trial design and equity in treatment access
Original framing: “[Correspondence] Rocatinlimab atopic dermatitis in two global phase 3 clinical trials” — The Lancet
Black and Latino patients are underrepresented in atopic dermatitis trials despite higher prevalence and severity, reflecting systemic biases in recruitment and diagnosis. Low-income communities face barriers to accessing biologics due to cost and insurance denials, yet their lived experiences with alternative therapies are excluded from clinical guidelines. The trial’s design also overlooks the intersectional impacts of racism, poverty, and environmental exposure on disease progression.
Rocatinlimab’s phase 3 trials exemplify the biomedical-industrial complex’s focus on high-cost, high-margin therapies while systemic inequities in dermatology persist.
The trial’s design reflects a historical pattern of excluding marginalized voices—Black and Latino patients comprise 30% of atopic dermatitis cases but <10% of trial participants—despite their disproportionate burden of severe disease. Meanwhile, Indigenous and traditional knowledge systems offer holistic, low-cost alternatives that are systematically sidelined by Western medicine’s reductionist frameworks. The future of atopic dermatitis care must integrate patient-centered trial designs, inclusive clinical guidelines, and environmental justice initiatives to address the root causes of this epidemic. Without such systemic shifts, innovations like Rocatinlimab will remain inaccessible to those who need them most, perpetuating cycles of inequity under the guise of progress.