Delgocitinib Leads to Strong 16-Week Improvement in Chronic Hand Eczema

The topical pan-Janus kinase (JAK) inhibitor delgocitinib (Anzupgo; LEO Pharma) has greater efficacy at treating chronic hand eczema (CHE) when compared with vehicle, as well as a favorable safety profile, according to a new meta-analysis of randomized controlled trials.

The study was published in the journal Experimental Dermatology.¹

Delgocitinib was the first topic treatment approved by regulators specifically to treat CHE, earning European Medicines Agency approval in 2024 and Food and Drug Administration approval the following year, the authors noted.

The traditional treatment for CHE is corticosteroids, but the investigators noted that prolonged use of corticosteroids has been linked with adverse effects including skin atrophy and delayed wound healing.²

The authors said the JAK family plays a key role in the pathogenesis of CHE, and so its blockage by delgocitinib and the therapy’s improvement of skin barrier function through STAT3 activation suppression appear to account for its efficacy.

Delgocitinib has been studied in at least 4 randomized controlled trials, but to date the only attempt to synthesize the data from those trials came in the form of a 2024 research letter, the authors explained.³ In the new report, the authors sought to provide a more comprehensive assessment of the available data, including an analysis of the treatment’s efficacy and different time points.

The 4 trials, which were reported in 3 published articles, included a total of 1,154 adult participants, of whom 752 received delgocitinib and the remaining 402 received vehicle. The investigators analyzed efficacy at weeks 4, 8, and 16, with 16-week treatment success serving as the primary outcome. Treatment success was defined as “clear or almost-clear” skin and at least a 2-point improvement on the Investigator’s or Physician’s Global Assessment (IGA/PGA).

A pooled analysis from the 3 trials for which 16-week data were available showed that 25.3% of patients receiving delgocitinib achieved treatment success, compared with 8.4% among patients who received vehicle (risk ratio [RR] 3.17; 95% CI, 1.78-5.65; P < .0001).

A pooled analysis of all 4 trials showed delgocitinib led to similar benefits at 4 weeks (15.1% treatment success vs. 6.2%; RR 2.32; 95% CI, 1.53-3.52; P < .0001) and at 8 weeks (28.7% vs. 9.3%; RR 2.93; 95% CI, 1.97-4.36; P < .00001).

“Importantly, the early statistical difference at week 4 highlights the potential impact on treatment adherence, as patients are more likely to persist with therapy when improvement is observed early in the treatment course,” the authors wrote.

Pooled data also showed an improvement in Hand Eczema Symptom Diary (HESD) itch and pain scores, which the investigators suggested may also lead to an improvement in patients’ quality of life.

In terms of safety, the investigators found no significant difference in overall adverse events (AEs), treatment-related AEs, or serious AEs between the delgocitinib cohort and the vehicle cohort. Just 0.7% of participants who received delgocitinib in their trial discontinued treatment, compared with 4.2% in the vehicle cohort. Safety data were only available up to week 16, but the authors said an open-label extension trial suggests that the therapy can be used for longer periods of time without additional safety concerns.⁴

The authors concluded that their findings show that delgocitinib appears to be an effective and well-tolerated topical treatment option for patients with CHE.

References:

1. de Moraes-Souza R, Bornia MJP, Chater RC, et al. Efficacy and safety of topical delgocitinib for chronic hand eczema: A systematic review and meta-analysis of randomized controlled trials. Exp Dermatol. 2026;35(4):e70242. doi:10.1111/exd.70242

2. Coondoo A, Phiske M, Verma S, Lahiri K. Side effects of topical steroids: A long overdue revisit. Indian Dermatol Online J. 2014;5(4):416-425. doi:10.4103/2229-5178.142483

3. Raja S, Raja A, Shuja MH, Ali A. Clinical benefits of delgocitinib cream for chronic hand eczema: a systematic review and meta-analysis. Arch Dermatol Res. 2024;316(10):734. Published 2024 Nov 1. doi:10.1007/s00403-024-03502-2

4. Gooderham M, Molin S, Bissonnette R, et al. Long-term safety and efficacy of delgocitinib cream for up to 52 weeks in adults with chronic hand eczema: Results of the phase 3 open-label extension DELTA 3 trial following the DELTA 1 and 2 trials. J Am Acad Dermatol. 2025;93(1):95-103. doi:10.1016/j.jaad.2025.03.008