[Comment] Closing the Middle East and north Africa representation gap in clinical trials in inflammatory bowel disease

Inflammatory bowel disease (IBD) has expanded beyond its initial confines of early industrialised countries in North America, Europe, and Oceania and now constitutes a global illness. Once rare in the Middle East and north Africa region, analyses using the Global Burden of Disease 2019 Study database showed a 30% increase in age-standardised IBD incidence from 1990 to 2019, with prevalence estimates at 48·3 per 100 000 people;1 a study by Hracs and colleagues analysing the global epidemiological evolution of IBD indicates that the Middle East and north Africa region is currently at stage 2, with growing incidence and rising prevalence.