Delgocitinib 20mg/g cream

Chronic hand eczema (CHE) is associated with substantial functional impairment and reduced quality of life. Delgocitinib, a pan-Janus kinase (JAK) inhibitor, has emerged as a promising topical treatment for CHE. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of topical delgocitinib 20-30 mg/g compared with vehicle in patients with CHE. PubMed, Embase, Cochrane Library, ClinicalTrials.gov, EU CTR, and WHO ICTRP were searched up to 15 February 2026. The primary outcome was treatment success at week 16, defined as clear or almost clear skin with a ≥ 2-point improvement on the Investigator's or Physician's Global Assessment (IGA/PGA). Secondary outcomes included treatment success at weeks 4 and 8, changes in Hand Eczema Symptom Diary (HESD) itch and pain scores, and safety outcomes. Relative risks (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Three publications reporting four RCTs involving 1154 patients were included, with 752 receiving delgocitinib and 402 receiving vehicle. At week 16, treatment success was significantly higher with delgocitinib (RR 3.17; 95% CI 1.78-5.65; p < 0.01), corresponding to an absolute risk difference of 16.9% and a number needed to treat (NNT) of 6 (95% CI 3-16). Similar results at weeks 4 and 8. Delgocitinib also led to significantly greater improvements in HESD itch and pain scores. No significant differences were found in overall adverse events (AEs), treatment-related AEs, or serious AEs. Discontinuation due to AEs was lower in the delgocitinib group. Delgocitinib 20-30 mg/g demonstrated greater efficacy than vehicle and a favourable safety profile, supporting its use as a topical treatment for CHE.

Abstract licence: CC BY-NC-ND 4.0

Background: Chronic hand eczema (CHE) is a persistent inflammatory skin condition that is often difficult to manage and associated with substantial functional impairment and reduced quality of life. Delgocitinib, a topical pan-Janus kinase inhibitor, has emerged as a potential nonsteroidal therapeutic option for CHE. Purpose: The purpose of this study was to evaluate the efficacy and safety of delgocitinib in adult patients with chronic hand eczema using evidence from randomized controlled trials. Research Design: This study was conducted as a systematic review and meta-analysis of randomized controlled trials. Study Sample: The study sample comprised individual randomized controlled trials that enrolled adult patients diagnosed with chronic hand eczema and compared topical delgocitinib with vehicle control. Data Collection and/or Analysis: A comprehensive literature search was performed to identify eligible randomized controlled trials. Data on treatment efficacy and adverse events were extracted and pooled using random-effects meta-analysis, with results expressed as odds ratios and 95% confidence intervals. Results: Pooled analysis demonstrated that delgocitinib significantly improved treatment outcomes compared with vehicle controls. The odds ratio for treatment success at week 8 was 3.53 (95% CI: 2.28–5.45), and at week 16 was 3.56 (95% CI: 1.93–6.57), indicating sustained efficacy over time. There was no significant increase in adverse events associated with delgocitinib use, with an odds ratio of 1.03 (95% CI: 0.79–1.60). Conclusions: Delgocitinib demonstrates significant and sustained efficacy in improving clinical outcomes in adult patients with chronic hand eczema, without an associated increase in adverse event risk. These findings support delgocitinib as an effective and well-tolerated nonsteroidal treatment option for chronic hand eczema.

Abstract licence: CC BY-NC 4.0

BackgroundThe lichen planus spectrum includes cutaneous, scalp, pigmentary, and nail phenotypes. Topical Janus kinase inhibitors offer targeted treatment with limited systemic exposure.ObjectiveTo map and critically appraise clinical, safety, and molecular evidence for topical Janus kinase inhibitors across lichen planus phenotypes.MethodsWe performed a PRISMA-guided systematic review (PROSPERO CRD420251155683) searching MEDLINE, Embase, Scopus, trial registries, and other sources to 1 November 2025. Human studies of topical JAK inhibitors for cutaneous lichen planus (LP), lichen planopilaris, frontal fibrosing alopecia (FFA), lichen planus pigmentosus (LPPig), or nail lichen planus were included. Risk of bias was assessed, certainty of evidence was graded, and findings were synthesized narratively.ResultsThirteen studies (n = 118 patients) and one registry trial were included. In FFA, a phase 2 double-blind, vehicle-controlled trial of delgocitinib 2% cream in 30 patients met its molecular primary endpoint and showed greater clinical improvements than vehicle over 12 weeks. Two cohorts reported improvement with topical tofacitinib 2% and topical ruxolitinib 1.5% in scarring alopecia. In cutaneous LP (n = 12), an open-label study showed improvement in lesion severity and symptoms with topical ruxolitinib. Evidence for LPPig and nail LP was limited to case reports. Topical JAK inhibitors were well tolerated with infrequent local irritation and no serious adverse events.ConclusionsTopical Janus kinase inhibitors appear promising, well tolerated, and potentially steroid-sparing, particularly in lichen planopilaris and FFA. However, the evidence remains limited, and well-designed vehicle-controlled trials are needed before routine use can be justified.

Abstract licence: CC BY

IntroductionChronic hand eczema (CHE) is a highly prevalent dermatology-related occupational hazard. This condition, which is a distinct diagnosis from atopic dermatitis (AD), can be quite symptomatic with implications for one's personal and professional life. Many therapeutic interventions exist for CHE, and the current study determined-through network meta-analyses (NMAs)-the relative efficacy of the newer treatments for CHE.MethodsData for eligible studies were identified after systematically reviewing the literature in PubMed and Scopus. Eligible studies were those that had an arm investigating the impact of monotherapy on 12- or 16-week changes in Hand Eczema Severity Index (HECSI) scores. We conducted sensitivity analyses where network meta-regressions were performed to (ecologically) adjust for variation due to age and sex. Base and sensitivity analyses were adjusted for disease severity at baseline.ResultsWe identified 5 eligible studies-across which there were 10 active comparators. Among the active comparators were two treatments approved by the Food and Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of CHE, namely, alitretinoin 30 mg once daily (oral) and delgocitinib 20 mg/g twice daily (topical). We estimated pairwise relative effects using the mean difference (i.e., mean reduction) in the respective HECSI scores; furthermore, efficacy was ranked with Surface Under the Cumulative Ranking Curve (SUCRA) values.ConclusionsWe attempted to contribute to the existing CHE literature by producing comparative information on its treatments' relative efficacy; moreover, we found no published NMA study on available treatments for CHE before the conduct of our work. Our results can guide clinical decision-making.

Abstract licence: CC BY

Background Chronic hand eczema (CHE) is a burdensome disease, and new well-documented, safe and efficacious treatments are warranted. In a recent CHE phase IIa trial, the pan-Janus kinase (JAK) inhibitor delgocitinib in an ointment formulation was found to be efficacious and well tolerated. Objectives This trial assessed the dose response, efficacy and safety of delgocitinib cream in CHE. Methods In this double-blind, phase IIb dose-ranging trial, adults with CHE and a recent history of inadequate response or contraindication to topical corticosteroids were randomized to delgocitinib cream 1, 3, 8, 20 mg g–1 or vehicle treatment twice daily for 16 weeks. The primary endpoint was the Investigator’s Global Assessment for CHE (IGA-CHE) treatment success [0 (clear) or 1 (almost clear) with a ≥ two-point improvement from baseline to week 16]. Secondary endpoints were the time to IGA-CHE treatment success and changes in Hand Eczema Severity Index (HECSI); other endpoints were itch and pain numerical rating scale (NRS) scores, and Patient’s Global Assessment (PaGA) at week 16. Results Patients (n = 258) were randomized 1 : 1 : 1 : 1 : 1 to delgocitinib cream 1, 3, 8, 20 mg g–1 or vehicle. A significant dose–response relationship was established for IGA-CHE (P < 0.025). IGA-CHE treatment success at week 16 was achieved in 21.2% (1 mg g–1), 7.8% (3 mg g–1), 36.5% (8 mg g–1), 37.7% (20 mg g–1) and 8.0% (vehicle) of patients. Delgocitinib 8 and 20 mg g–1 showed a treatment effect against vehicle (P < 0.001). Similarly, there were improvements in HECSI, itch and pain NRS scores, and PaGA. Delgocitinib cream was well tolerated with the majority of adverse events being mild or moderate and considered unrelated to treatment. The most frequently reported adverse events were nasopharyngitis (17.3–29.4% in delgocitinib groups vs. 40% in vehicle group), eczema (5.8–11.3% in delgocitinib groups vs. 16.0% in vehicle group) and headache (3.8–11.5% in delgocitinib groups vs. 4.0% in vehicle group). Conclusions In this trial, delgocitinib cream showed a dose–response relationship in terms of efficacy and was well tolerated.

Abstract licence: CC BY-NC 4.0