Drugs for the Treatment of Chronic Hand Eczema: Successes and Key Challenges

Figures & data

Table 1 Relevant Clinical Trials for the Treatment of Chronic Hand Eczema

	Agent	Target / Mechanism	Clinical Trial Status	Clinical Trial Number	Reference
Topical	LEO 19,123	Calcipotriol	Completed in 2007	NCT00404196	LEO19123 Cream in the Treatment of Hand Eczema. In: https://ClinicalTrials.gov/show/NCT00404196.^Citation148
	Pimecrolimus	Calcineurin/FKBP	Completed in 2008	NCT00226707	Pimecrolimus Cream 1% in Patients (18 Years of Age and Over) With Mild to Moderate Chronic Hand Dermatitis. In: https://ClinicalTrials.gov/show/NCT00226707.^Citation63
	Tacrolimus	Calcineurin/FKBP	Completed in 2008	__________	Schliemann, et al Tacrolimus ointment in the treatment of occupationally induced chronic hand dermatitis. Contact dermatitis. 2008;58(5):299–306.^Citation64
	Clobetasol propionate	Corticosteroid	Completed in 2012	NCT00828464	Study to Evaluate Safety, Efficacy and Tolerability of Clobetasol Propionate for Chronic Hand Dermatitis. In: https://ClinicalTrials.gov/show/NCT00828464.^Citation71
	Triamcinolone acetonide	Corticosteroid	Completed in 2012	NCT00890968	Safety and Efficacy Study of Triamcinolone Acetonide DuraPeel to Treat Hand Dermatitis. https://ClinicalTrials.gov/show/NCT00890968.^Citation73
	Halometasone triclosan	Corticosteroid	Completed in 2018	NCT03246776	Microbial Colonization and Change of Chronic Keratinized Hand Eczema After Using Halometasone Triclosan. In: https://ClinicalTrials.gov/show/NCT03246776.^Citation77
	Delgocitinib (LEO 124,249)	Pan-JAK	Completed in 2018 Completed in 2020	NCT02664805 NCT03683719	1. Proof of Concept, Twice Daily Applications of LEO 124,249 Ointment in the Treatment of Chronic Hand Eczema. In: https://ClinicalTrials.gov/show/NCT02664805.^Citation83 2. Phase 2b Dose-ranging Trial to Evaluate Delgocitinib Cream 1, 3, 8, and 20 mg/g Compared to Delgocitinib Cream Vehicle Over a 16-week Treatment Period in Adult Subjects With Chronic Hand Eczema. In: https://ClinicalTrials.gov/show/NCT03683719.^Citation84
	Roflumilast (ARQ-252)	PDE4	Ongoing Phase 1/2b	NCT04378569	Safety and Efficacy of ARQ-252 Cream in Subjects With Chronic Hand Eczema. In: https://ClinicalTrials.gov/show/NCT04378569.^Citation37
	AFX 5931	CCL5/CCL2	Completed in 2019	NCT03703895	A Study for a Topical Medication Versus Placebo in Patients With Hand Dermatitis. In: https://ClinicalTrials.gov/show/NCT03703895.^Citation38
Systemic	Alitretinoin	Vitamin A derivative	Approved in EU, Canada, Israel, and South Korea	1. NCT00124475 2. NCT00817063	1. Ruzicka, et al Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial. British Journal of Dermatology. 2008;158(4):808–817.^Citation99 2. Fowler et al. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of alitretinoin (BAL4079) in the treatment of severe chronic hand eczema refractory to potent topical corticosteroid therapy. Journal of Drugs in Dermatology. 2014;13(10):1198–1204.^Citation103
	Acitretin	Vitamin A derivative	Completed in 2014	NCT01545284	Pilot Study on the Use of Acitretin for the Treatment of Severe Chronic Hand Dermatitis. In: https://ClinicalTrials.gov/show/NCT01545284.^Citation113
	Cyclosporine	Calcineurin/NFAT	Ongoing Phase 3	NCT03026946	Alitretinoin vs Cyclosporine in Severe Recurrent Vesicular Hand Eczema. In: https://ClinicalTrials.gov/show/NCT03026946.^Citation114
	Azathioprine	DNA synthesis	Ongoing Phase 3	NCT03026907	Alitretinoin vs Azathioprine in Severe Non-hyperkeratotic Hand Eczema. In: https://ClinicalTrials.gov/show/NCT03026907.^Citation115
	Gusacitinib (ASN002)	JAK/SYK	Completed in 2020	NCT03728504	Study to Evaluate ASN002 in Subjects With Moderate To Severe Chronic Hand Eczema. In: https://ClinicalTrials.gov/show/NCT03728504.^Citation50
	Dupilumab	IL-4Ra	Ongoing Phase 2	NCT03861455	Efficacy and Safety of Dupilumab Chronic Hands Eczema Refractory to Highly Potent Topical Corticosteroids. In: https://ClinicalTrials.gov/show/NCT03861455.^Citation52

LEO 19123 cream in the treatment of hand eczema. Available from: https://ClinicalTrials.gov/show/NCT00404196. Accessed December 21, 2020.

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Pimecrolimus cream 1% in patients (18 years of age and over) with mild to moderate chronic hand dermatitis. Available from: https://ClinicalTrials.gov/show/NCT00226707. Accessed December 21, 2020.

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Schliemann S, Kelterer D, Bauer A, et al. Tacrolimus ointment in the treatment of occupationally induced chronic hand dermatitis. Contact Dermatitis. 2008;58(5):299–306. doi:10.1111/j.1600-0536.2007.01314.x

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Study to evaluate safety, efficacy and tolerability of clobetasol propionate for chronic hand dermatitis. Available from: https://ClinicalTrials.gov/show/NCT00828464. Accessed December 21, 2020.

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Safety and efficacy study of triamcinolone acetonide durapeel to treat hand dermatitis. Available from: https://ClinicalTrials.gov/show/NCT00890968. Accessed December 21, 2020.

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Microbial colonization and change of chronic keratinized hand eczema after using halometasone triclosan. Available from: https://ClinicalTrials.gov/show/NCT03246776. Accessed December 21, 2020.

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Proof of concept, twice daily applications of LEO 124249 ointment in the treatment of chronic hand eczema. Available from: https://ClinicalTrials.gov/show/NCT02664805. Accessed December 21, 2020.

 Google Scholar

Phase 2b dose-ranging trial to evaluate delgocitinib cream 1, 3, 8, and 20 mg/g compared to delgocitinib cream vehicle over a 16-week treatment period in adult subjects with chronic hand eczema. Available from: https://ClinicalTrials.gov/show/NCT03683719. Accessed December 21, 2020.

 Google Scholar

Safety and efficacy of ARQ-252 cream in subjects with chronic hand eczema. Available from: https://ClinicalTrials.gov/show/NCT04378569. Accessed December 21, 2020.

 Google Scholar

A study for a topical medication versus placebo in patients with hand dermatitis. Available from: https://ClinicalTrials.gov/show/NCT03703895. Accessed December 21, 2020.

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Ruzicka T, Lynde CW, Jemec GB, et al. Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial. Br J Dermatol. 2008;158(4):808–817. doi:10.1111/j.1365-2133.2008.08487.x

 PubMed Web of Science ®Google Scholar

Fowler JF, Graff O, Hamedani AG. A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of alitretinoin (BAL4079) in the treatment of severe chronic hand eczema refractory to potent topical corticosteroid therapy. J Drugs Dermatol. 2014;13(10):1198–1204.

 PubMed Web of Science ®Google Scholar

Pilot study on the use of acitretin for the treatment of severe chronic hand dermatitis. Available from: https://ClinicalTrials.gov/show/NCT01545284. Accessed December 21, 2020.

 Google Scholar

Alitretinoin vs cyclosporine in severe recurrent vesicular hand eczema. Available from: https://ClinicalTrials.gov/show/NCT03026946. Accessed December 21, 2020.

 Google Scholar

Alitretinoin vs azathioprine in severe non-hyperkeratotic hand eczema. Available from: https://ClinicalTrials.gov/show/NCT03026907. Accessed December 21, 2020.

 Google Scholar

Study to evaluate ASN002 in subjects with moderate to severe chronic hand eczema. Available from: https://ClinicalTrials.gov/show/NCT03728504. Accessed December 21, 2020.

 Google Scholar

Efficacy and safety of dupilumab chronic hands eczema refractory to highly potent topical corticosteroids. Available from: https://ClinicalTrials.gov/show/NCT03861455. Accessed December 21, 2020.

 Google Scholar