Delgocitinib cream superior to oral alitretinoin for severe chronic hand eczema

In the treatment of patients with severe chronic hand eczema, delgocitinib cream appears to have better safety and efficacy compared with oral alitretinoin, according to the results of the phase III DELTA FORCE trial.

A total of 513 adult patients (65 percent female) were enrolled at 102 trial centres across Austria, Canada, France, Germany, Italy, Norway, Poland, Slovakia, Spain, and the UK. These patients were randomly assigned to treatment with delgocitinib cream 20 mg/g (applied twice daily; n=254) or alitretinoin 30 mg (taken once daily; n=259) for up to 24 weeks.

Change in Hand Eczema Severity Index (HECSI) score from baseline to week 12 was evaluated as the primary endpoint. Safety was also assessed. The full analysis set included 250 patients in the delgocitinib group and 253 in the alitretinoin group. One patient in the delgocitinib group and three in the alitretinoin group were excluded from the primary analysis as they had missing HECSI data at baseline.

At week 12, the least squares mean change in HECSI score was significantly greater in the delgocitinib group than in the alitretinoin group (–67.6 vs –51.5; difference, –16.1, 95 percent confidence interval, –23.3 to –8.9; p<0.0001).

Adverse events (AEs) occurred less frequently among patients in the delgocitinib group than among those in the alitretinoin group (49 percent vs 76 percent). The most common AEs were headache (4 percent in the delgocitinib group vs 32 percent in the alitretinoin group), nasopharyngitis (12 percent vs 14 percent, respectively), and nausea (<1 percent vs 6 percent, respectively).

The findings provide evidence of the beneficial effect of delgocitinib cream in patients with severe chronic hand eczema.