Toctino (alitretinoin) / Basilea - LARVOL DELTA

P015 Clinical characteristics of patients and treatment of moderate-to-severe chronic hand eczema in the UK: the RWEAL study. (PubMed, Br J Dermatol) - "Among 183 patients treated by dermatologists, 11% received alitretinoin, 10% phototherapy, 10% methotrexate, 8% ciclosporin and 7% dupilumab during the past 12-month period. This indicates a need for new treatment options that address the heterogeneous and multifactorial nature of CHE. The absence of clear lines of treatment after TCS suggests a need for UK-specific guidelines for CHE."

Journal • Retrospective data • Atopic Dermatitis • Contact Dermatitis • Dermatitis • Dermatology • Immunology • Pruritus

Comparative Efficacy of Monotherapies for Chronic Hand Eczema: A Network Meta-Analysis Study. (PubMed, J Cosmet Dermatol) - "We 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."

Journal • Retrospective data • Atopic Dermatitis • Contact Dermatitis • Dermatitis • Dermatology • Immunology

Cost-Effectiveness of Delgocitinib vs. PUVA in Patients With Moderate-to-Severe Chronic Hand Eczema (ISPOR-EU 2025) - "OBJECTIVES: Delgocitinib cream and psoralen with ultraviolet A (PUVA) light therapy are treatment options for patients with moderate or severe Chronic Hand Eczema (CHE) which has not adequately responded to treatment with topical corticosteroids...Efficacy and utility evidence for delgocitinib were derived from the DELTA 1, DELTA 2 clinical trials versus vehicle cream, and DELTA FORCE clinical trial versus alitretinoin... For treatment of patients with moderate-to-severe CHE which is inadequately treated by topical corticosteroids, delgocitinib cream provides both better clinical outcomes and lower costs for the healthcare payer in comparison with PUVA in the UK healthcare context."

Clinical • Cost effectiveness • HEOR • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology

Comparative Efficacy and Safety of Delgocitinib, Alitretinoin, and PUVA in Patients With Moderate-to-Severe Chronic Hand Eczema: A Network Meta-Analysis (ISPOR-EU 2025) - "OBJECTIVES: Delgocitinib cream, alitretinoin, and psoralen with ultraviolet A (PUVA light therapy) are treatments used amongst patients with Chronic Hand Eczema (CHE) which has not adequately responded to topical corticosteroids alone. Due to limitations of available data, assumptions were required related to comparability of the IGA-CHE and PGA severity assessment tools, disease severity, treatments and outcome assessment timepoints, and the use of non-responder imputation. Notwithstanding these assumptions, amongst patients with moderate/severe CHE, treatment with delgocitinib cream is associated with both higher rates of treatment response and lower rates of discontinuation due to adverse events than either alitretinoin or PUVA light therapy."

Retrospective data • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology

INDIVIDUAL ARTICLE: The Utility of Delgocitinib in Chronic Hand Eczema. (PubMed, J Drugs Dermatol) - "Comparative studies suggest delgocitinib offers superior or similar benefits to systemic therapies like the oral retinoid alitretinoin and the biologic dupilumab, with negligible systemic exposure. These findings support delgocitinib cream as an innovative and promising topical therapy addressing a critical unmet need in CHE patient management."

Journal • Review • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology

Physician-Reported Treatment Patterns in Moderate to Severe Chronic Hand Eczema: the RWEAL Multinational Medical Chart Review. (PubMed, Dermatol Ther (Heidelb)) - "Despite being a first-line treatment, 40% of patients with CHE were inadequately treated with or contraindicated to TCS. Over one-quarter of patients progressed to phototherapy or systemic therapy. These results suggest a lack of effective and well-tolerated topical treatment options in CHE. Graphical Abstract available for this article."

Journal • Atopic Dermatitis • Contact Dermatitis • Dermatitis • Dermatology • Immunology

Treatment of Refractory PRP with Off-label Guselkumab and Abrocitinib: A Promising Combination Therapy (EADV 2025) - "She had failed NBUVB phototherapy, cyclosporine, topical steroids and keratolytics, prednisone, and was currently taking acitretin alternating dose 25mg/35mg daily...She started combination of methotrexate and acitretin which failed. Ustekinumab 90mg every twelve weeks was initiated off-label with alitretinoin 30mg daily; no change... My case highlights that combination therapy of an IL-23 and JAK inhibitor are effective off-label in PRP. Current treatments approved for both psoriasis and atopic dermatitis seem to provide benefit, and combination therapy may be more beneficial. More research is necessary to find an effective single agent or to identify ideal doses of combination therapies."

Combination therapy • Atopic Dermatitis • Dermatitis • Dermatology • Dermatopathology • Inflammation • Pruritus • Psoriasis • IL23A

Burden of Chronic Hand Eczema (CHE) in France Using the French Nationwide Claims Database (EADV 2025) - "Materials & Observational cohort study of CHE patients identified using the SNDS between 2017 and 2021, which included two groups: i) Alitretinoin CHE group: patients with at least one alitretinoin dispensing (first dispensing as index date); ii) Algorithm-based CHE group: patients identified using an algorithm combining sick leave in high-risk professions (medical sector; butchery, food industry and catering; print shop; hair and beauty care; traditional and industrial bakeries; construction/building; cleaning activity; maintenance and repair of motor vehicles), and concomitant dispensing of potent TCS, ciclosporin, topical tacrolimus, antihistamines, oral alitretinoin, or methotrexate (first sick leave as index date). This study highlights the CHE burden with a significant extra cost and impact on patients' professional activity and mental health. Moreover, these results demonstrate the need for alternatives to repeated, prolonged use of TCS in CHE and for..."

Claims database • Atopic Dermatitis • CNS Disorders • Contact Dermatitis • Depression • Dermatology • Immunology • Mood Disorders • Psychiatry • Sleep Disorder

Drug survival of systemic off-label therapies for treatment of hand eczema (EADV 2025) - "First- line treatment includes trigger avoidance, emollients, and topical corticosteroids (TCS) or topical calcineurin inhibitors (TCI), and recently delgocitinib was approved as an additional topical treatment option. Alitretinoin is the only systemic treatment approved for HE, however a large proportion of patients receive off-label therapies when initiating systemic therapy...Off-label treatment included acitretin, azathioprine, cyclosporine, dupilumab, methotrexate and mycophenolate mofetil... Drug survival of traditional systemic therapies was comparable with cyclosporine showing slightly higher drug survival compared to acitretin, but comparable to most other systemic therapies. Dupilumab demonstrated the highest drug survival among off-label treatments, potentially reflecting higher efficacy and tolerability. This may indicate that most off-label treatment options in HE are inadequate in achieving disease control."

Asthma • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology • Respiratory Diseases

Matching-Adjusted Indirect Comparison of the Efficacy at week 12 of Delgocitinib and topical PUVA in the treatment of Severe Chronic Hand Eczema (EADV 2025) - P3 | "Current therapies, including topical corticosteroids, phototherapy (including psoralen ultraviolet A [PUVA]), and alitretinoin (approved for severe CHE in Europe, Canada, Israel and South Korea), may be hindered by side effects and poor patient adherence. The results of this MAIC analysis demonstrate that treatment with delgocitinib significantly improves both clinical and quality-of-life outcomes compared to PUVA plus as required TCS in severe CHE at week 12, including PGA/IGA-CHE, HECSI, and DLQI. These findings support delgocitinib as a highly efficacious and accessible alternative to PUVA ± TCS for managing severe CHE. As a topical treatment, delgocitinib also offers a more convenient alternative to PUVA based treatment, reducing the need for frequent clinic visits, alongside offering a favourable tolerability and safety profile."

Clinical • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology

Abrocitinib in combination with dupilumab for refractory atopic chronic hand eczema (EADV 2025) - "Treatment history included ultra-potent topical corticosteroids, topical calcineurin inhibitors, prednisone, methotrexate, cyclosporine, azathioprine and phototherapy...We recommended starting oral alitretinoin, but the patient could not afford it... The combination of biologic (dupilumab) and JAKi (abrocitinb) could be a favorable option for refractory severe atopic dermatitis, especially in cases with recalcitrant chronic hand eczema."

Combination therapy • Allergic Rhinitis • Asthma • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology • Pruritus • Respiratory Diseases • IL13 • IL22 • IL4

Safety of delgocitinib cream in adult patients with Chronic Hand Eczema (CHE): pooled analysis of five phase 2b and phase 3 trials (EADV 2025) - P2 | "Data encompass both the initial treatment period (ITP; delgocitinib cream twice daily [BID] vs cream vehicle BID or alitretinoin once daily for 12-16 weeks) and the subsequent as-needed treatment period (DELTA 3 and DELTA FORCE; delgocitinib cream 20 mg/g BID for up to 52 weeks of total treatment). The safety profile of delgocitinib cream during the as-needed treatment period remained consistent with the ITP, with AE rates decreasing in frequency over time. These pooled safety data support the robust safety profile of delgocitinib cream 20 mg/g for up to 52 weeks of treatment in adults with CHE."

Late-breaking abstract • P2b data • P3 data • Retrospective data • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology • Infectious Disease

Delgocitinib 20 mg/g Cream: A Review in Chronic Hand Eczema. (PubMed, Drugs) - "Moreover, an active-controlled trial demonstrated that delgocitinib 20 mg/g cream had superior efficacy and apparent improved tolerability versus oral alitretinoin in adults with severe CHE. In summary, current data show that delgocitinib 20 mg/g cream is an efficacious and well tolerated treatment for moderate to severe CHE in adults. As the first topical treatment specifically approved for CHE, it presents a valuable new non-steroidal option in patients for whom topical corticosteroids are inadequate or inappropriate."

Journal • Review • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology

Treatment of Refractory PRP with Off-label Guselkumab and Abrocitinib: A Promising Combination Therapy (CDA 2025) - "She had failed NBUVB phototherapy, cyclosporine, topical steroids and keratolytics, prednisone, and was currently taking acitretin alternating dose 25mg/35mg daily...She started combination of methotrexate and acitretin which failed. Ustekinumab 90mg every twelve weeks was initiated off-label with alitretinoin 30mg daily; no change...Current treatments approved for both psoriasis and atopic dermatitis seem to provide benefit, and combination therapy may be more beneficial. More research is necessary to find an effective single agent or to identify ideal doses of combination therapies."

Combination therapy • Atopic Dermatitis • Dermatitis • Dermatology • Dermatopathology • Immunology • Pruritus • Psoriasis • IL23A

Screening for Potential Compounds Using Drug-Repurposing of N-Methyl-D-Aspartate (NMDA) Receptor for Autism Spectrum Disorder (ASD). (PubMed, Trop Life Sci Res) - "The drugs were alitretinoin, salicylic acid and indinavir, respectively. Finally, ADMET (Absorption, Distribution, Metabolism, Excretion and Toxicity) predictions identify 4-androstenedione, tryptophan, carbocisteine and vitamin A as having minimal toxic effects. This study showed that alitretinoin, which was known to treat skin lesions from Kaposi's sarcoma, might have the ability to reverse the effect in ASD, particularly in NMDA receptors, potentially making a significant impact on the field of neurology and psychiatry."

Journal • Autism Spectrum Disorder • Genetic Disorders • Kaposi Sarcoma • Oncology • Psychiatry • Sarcoma • Solid Tumor • NRXN1

Kaposi sarcoma manifesting as leg lesions in a patient with diabetes mellitus: A case report (ESPE-ESE 2025) - "Then, the patient underwent treatment with topical alitretinoin 0.1% gel by dermatology... Our case illustrates the potential association between diabetes and Kaposi’s sarcoma and emphasizes the importance of clinical examination in the detection of tumor lesions in diabetics. Rigidly control glucose levels were required allowing for long-term remission and reduction of complications."

Case report • Clinical • Dermatology • Diabetes • Epstein-Barr Virus Infections • Infectious Disease • Kaposi Sarcoma • Metabolic Disorders • Oncology • Sarcoma • Solid Tumor • Type 2 Diabetes Mellitus • CD34

Efficacy and safety of topical delgocitinib cream versus oral alitretinoin capsules in adults with severe chronic hand eczema (DELTA FORCE): a 24-week, randomised, head-to-head, phase 3 trial. (PubMed, Lancet) - P3 | "Delgocitinib cream showed superior efficacy and a more favourable safety profile versus oral alitretinoin over 24 weeks. These results support the benefit of delgocitinib cream in patients with severe chronic hand eczema."

Head-to-Head • Journal • P3 data • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology • Infectious Disease • Pain

Palmoplantar plaque psoriasis responsive to upadacitinib: A report of two cases. (PubMed, SAGE Open Med Case Rep) - "The first patient had failed topical therapies, phototherapy, acitretin, and secukinumab. The second patient had failed topical therapies and systemic agents including alitretinoin, cyclosporine, apremilast, ustekinumab, ixekizumab, and risankizumab...This case series highlights the efficacy of upadacitinib in two patients with refractory palmoplantar plaque psoriasis. JAK1 inhibitors may be considered as third-line therapeutic options in patients with refractory palmoplantar plaque psoriasis and no contraindications to JAK inhibitors."

Journal • Dermatology • Immunology • Psoriasis

The Efficacy and Safety of Non-Biologic and Biologic Treatments in Palmoplantar Pustular Psoriasis and Palmoplantar Pustulosis: A Systematic Review and Network Meta-Analysis. (PubMed, Australas J Dermatol) - "Based on the P-scores from our NMA, guselkumab 100 mg was the most effective for PPPGA improvement, guselkumab 100 mg for PPPASI-75, oral cyclosporine 1 mg/kg/day for PPPASI-50, etretinate 1 mg/kg/day had the most adverse events, and secukinumab 300 mg was associated with the highest rate of serious adverse events. TRIAL REGISTRATION: PROSPERO registration number: CRD42023460842."

Journal • Retrospective data • Review • Dermatology • Immunology • Psoriasis • Pustular Psoriasis

Alitretinoin is not a suitable treatment for the majority of chronic hand eczema patients. (PubMed, J Eur Acad Dermatol Venereol) - No abstract available

Journal • Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology

Development of immune-derived molecular markers for preeclampsia based on multiple machine learning algorithms. (PubMed, Sci Rep) - "Moreover, the immune-derived hub genes for PE exhibited strong binding capabilities with drugs, such as alitretinoin, tretinoin, and acitretin. Our results indicate that these biomarkers may outperform previously reported molecular signatures in predicting PE and provide insights into the mechanisms underlying immune dysregulation in PE. Further validation in larger cohorts could lead to their clinical application in PE prediction and treatment."

Biomarker • Journal • Cardiovascular • Gynecology

Successful Treatment of Refractory Palmoplantar Pustulosis Using JAK1 Inhibitors and Tyk2 Inhibitors: A Case Series of 10 Patients (EADV 2024) - "Since IFN- α is mediated by Tyk2, IFN- γ is mediated by JAK1, and IL-19 is mediated by both, we sought to assess the therapeutic response of patients with PPP to JAK1 inhibition via abrocitinib or upadacitinib or to Tyk2 inhibition via deucravacitinib...Prior to initiation of treatment with a JAK1 or Tyk2 inhibitor, patients had failed to respond to an average of 2.1 other treatments for PPP, including acitretin (60%) , methotrexate (30%) , cyclosporine (20%) , secukinumab (20%) , guselkumab (20%) , risankizumab (20%) , ixekizumab (20%) , apremilast (10%) , tildrakizumab (10%) , and narrow band UV combined with oral alitretinoin (10%)... To date, there have been only a few case series and reports published on the treatment of PPP with JAK1 inhibitors, and none on the treatment of PPP with Tyk2 inhibitors. Our case series provides compelling evidence that JAK1 and Tyk2 inhibitors are promising treatment options for PPP, including in cases refractory to conventional..."

Clinical • Celiac Disease • Dermatology • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Psoriasis • Psoriatic Arthritis • Rheumatoid Arthritis • Rheumatology • Seronegative Spondyloarthropathies • Systemic Lupus Erythematosus • TYK2

Alitretinoin versus phototherapy as the first-line treatment in adults with severe chronic hand eczema: the ALPHA RCT. (PubMed, Health Technol Assess) - "When education, irritant/contact allergen avoidance, moisturisation and topical corticosteroids are insufficient to control chronic hand eczema, ultraviolet therapy or systemic immune-modifying drugs are used. 59. See the NIHR Funding and Awards website for further award information."

Clinical • Journal • Atopic Dermatitis • Contact Dermatitis • Dermatitis • Dermatology • Immunology

Acitretin for the treatment of Kaposi Sarcoma: case report and review of the literature. (EADV 2024) - "Case Presentation: A 66-year-old woman with a history of seronegative rheumatoid arthritis currently treated with tofacitinib, methotrexate, and folic acid, presented with a several-month history of asymptomatic cutaneous lesions. We present a case of iatrogenic KS successfully treated with oral acitretin, showcasing the potential benefits of systemic retinoids in this vascular neoplasm."

Case report • Clinical • Review • Epstein-Barr Virus Infections • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammatory Arthritis • Kaposi Sarcoma • Oncology • Rheumatoid Arthritis • Rheumatology • Sarcoma • Solid Tumor

Charting a New Course: Tralokinumab in the Treatment of Refractory Hand Eczema (EADV 2024) - "Only alitretinoin is indicated for use up to 24 weeks. Hand eczema is a common and often severe and refractory condition. Tralokinumab may represent an effective treatment for this condition. Clinical trials are needed to assess the efficacy of biological therapies and available anti-JAKs for atopic dermatitis in hand eczema."

Atopic Dermatitis • Contact Dermatitis • Dermatology • Immunology