Delgocitinib for treating moderate to severe chronic hand eczema

Chronic Hand Eczema (CHE) is one of the most frequent chronic inflammatory skin diseases affecting hands and wrists.

CHE is a heterogeneous disease associated with pain, pruritus and substantial occupational, functional, social and psychological burden.

Delgocitinib, a novel topical non‐steroidal pan‐Janus kinase (JAK) inhibitor impacting JAK enzymatic activity and targeting key mediators of CHE with broad anti‐inflammatory effects has been approved for use by the European Medicines Agency for the treatment of moderate to severe CHE in adults for whom topical corticosteroids are inadequate or inappropriate (1):

• in the DELTA 1 and DELTA 2 Phase 3 trials, twice‐daily delgocitinib cream 20 mg/g was well tolerated and demonstrated significant improvement in all primary and key secondary efficacy endpoints in patients with CHE
• topical delgocitinib cream formulation has been developed to ensure topical absorption at the site of application (i.e. skin of the hands) and ease of use
• a minimal systemic exposure of topical delgocitinib cream was shown in patients with moderate to severe CHE compared with oral administration of delgocitinib
  • relative bioavailability for delgocitinib cream 20 mg/g versus different oral doses was 0.6%
  • these data support that no meaningful systemic pharmacological effect is expected with twice‐daily application of delgocitinib cream 20 mg/g in patients with moderate to severe CHE
• delgocitinib 20 mg/g cream was well tolerated locally in clinical trials, with low systemic exposure with topical application (2)

NICE state (3):

• delgocitinib can be used, within its marketing authorisation, as an option to treat moderate to severe chronic hand eczema in adults when topical corticosteroids have not worked or are not suitable
  • delgocitinib can only be used if the company provides it according to the commercial arrangement
• delgocitinib should be started and monitored by a healthcare professional with experience in diagnosing and treating chronic hand eczema in secondary care
• consider how skin colour could affect the assessment of severity and make any adjustments needed

The NICE committee noted:mittee noted that:

"..Usual treatment for moderate to severe chronic hand eczema when topical corticosteroids have not worked or are not suitable includes phototherapy (ultraviolet light therapy) or alitretinoin...Clinical trial evidence shows that delgocitinib is more effective at improving symptoms of chronic hand eczema than alitretinoin or 'vehicle cream' (a cream that does not contain an active ingredient)..Delgocitinib has not been directly compared in a clinical trial with phototherapy, but an indirect comparison suggests that delgocitinib is more effective.."

Reference:

1. Thaci D et al. Systemic exposure and bioavailability of delgocitinib cream in adults with moderate to severe Chronic Hand Eczema. J Eur Acad Dermatol Venereol. 2025 Sep;39(9):1612-1621.
2. McGuigan A, Shirley M. Delgocitinib 20 mg/g Cream: A Review in Chronic Hand Eczema. Drugs. 2025 Sep;85(9):1153-1162.
3. NICE (November 2025). Delgocitinib for treating moderate to severe chronic hand eczema