Dupilumab for hand eczema

Zirwas, Matthew J.

doi:10.1016/j.jaad.2018.02.073

Cited by 32 publications

(27 citation statements)

References 4 publications

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“…24,26 Recent observational studies showed promising results regarding the effectiveness of dupilumab in patients with hand eczema and might offer future perspectives for patients with difficult-to-treat vesicular hand eczema. 27,28 Treatment adherence was significantly lower in patients receiving nonsystemic treatment compared with systemic treatment. The perception of the relative ineffectiveness and inconvenience of topical treatment and sometimes corticophobia are well known in dermatology.…”

Section: Discussionmentioning

confidence: 98%

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Quality of life, treatment satisfaction, and adherence to treatment in patients with vesicular hand eczema: A cross‐sectional study

et al. 2020

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Background Recurrent vesicular hand eczema frequently has a chronic course and needs long‐term treatment. Objectives To evaluate health‐related quality of life (HRQoL), treatment satisfaction, and adherence in patients with vesicular hand eczema. Methods Patients using one main treatment for at least three months were included. Data on HRQoL (Quality of Life in Hand Eczema Questionnaire [QOLHEQ]), treatment satisfaction (Treatment Satisfaction Questionnaire for Medication, version II), and treatment adherence (4‐item Morisky Medication Adherence Scale) were collected. Univariate and multivariate regression analysis were used to predict variables associated with HRQoL. Results HRQoL was moderately impaired, with the highest impact in the QOLHEQ subdomain symptoms. Female sex, more severe hand eczema, and lower treatment satisfaction were associated with more impairment in HRQoL. Patients with severe/very severe hand eczema had significant lower “global satisfaction” scores compared with the other severity groups. The “global satisfaction” and treatment adherence in patients using systemic treatment were significantly higher compared with those with only topical treatment. Conclusions In patients with vesicular hand eczema disease severity affects both HRQoL and treatment satisfaction. Systemic treatment of severe hand eczema could improve the severity and as a result also HRQoL, treatment satisfaction, and medication adherence.

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Section: Discussionmentioning

confidence: 98%

“…The use of biologicals for psoriasis resulted in substantially higher global patient satisfaction scores . Recent observational studies showed promising results regarding the effectiveness of dupilumab in patients with hand eczema and might offer future perspectives for patients with difficult‐to‐treat vesicular hand eczema …”

Section: Discussionmentioning

confidence: 99%

Quality of life, treatment satisfaction, and adherence to treatment in patients with vesicular hand eczema: A cross‐sectional study

et al. 2020

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“…In a chart review of three adults with palmar CHE recalcitrant to TCS and tacrolimus, dupilumab (600 mg subcutaneously on Day 1 followed by 300 mg subcutaneously every 14 days) led to improvement in all three cases. A 72‐year‐old female patient with >35 year history of CHE achieved complete clearance in 6 weeks, a 65‐year‐old female patient with >10 year history of CHE achieved 90% improvement in 6 weeks, and a 48‐year‐old male with 9‐year history of CHE achieved 80% improvement in 3 months, based on investigator subjective improvement (Zirwas, ). In a separate report, a 50‐year‐old female with an 18‐year history of severe atopic CHE refractory to potent TCS, psoralen UV‐A, cyclosporine, alitretinoin, and tacrolimus was successfully treated with dupilumab (loading dose of 600 mg subcutaneously and 300 mg once every 2 weeks) concomitantly with prednisolone 7.5 mg/day, for 12 weeks (Oosterhaven, Romeijn, & Schuttelaar, ).…”

Section: Systemic Agentsmentioning

confidence: 99%

Current and emerging therapies for hand eczema

Lee

Maarouf

Hendricks

et al. 2019

Dermatologic Therapy

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Although hand eczema (HE) and chronic hand eczema (CHE) are common conditions with significant disease burden, they traditionally have had limited treatment options beyond topical and short‐term systemic corticosteroids. We reviewed published and preliminary evidence on the current and emerging topical and systemic therapeutic agents for HE and CHE. The etiologies of various HE subtypes are discussed, and remaining knowledge and practice gaps are highlighted to encourage further investigations. A comprehensive search of http://clinicaltrials.gov and PubMed was completed for clinical trials that utilized known and emerging treatment options for HE and CHE. Several agents that target IL‐4 and IL‐13 signaling, keratinocyte proliferation, inflammatory cytokine production, bacterial protein synthesis, and inflammatory mediator (TNF‐α, JAK1, JAK2, and JAK3) proliferation are shown to be involved in the pathogenesis of CHE. Systemic agents include dupilumab, alitretinoin, acitretin, cyclosporine, azathioprine, and probiotics. Topical agents include delgocitinib, retapamulin, halometasone/triclosan, calcipotriol/betamethasone, tacrolimus, and pimecrolimus. These modalities have demonstrated varying degrees of clinical efficacy, evaluated by subjective assessments and scoring indexes. Targeted therapies are emerging for HE, but options are still limited, partially due to our narrow understanding of this heterogeneous condition. Additional and targeted therapeutic options are needed to match the rising prevalence and burden of HE. Keypoints Hand eczema (HE) is a heterogenous dermatosis with limited therapeutic options due to a lack of international guidelines regarding classification of HE subtypes and treatment. This review discusses current and emerging topical and systemic agents and their efficacies in the treatment of different types of hand eczema.

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“…At the beginning of treatment, her Hand Eczema Severity Index Score (HESI) was 244 out of 360, and by week 16, her hand eczema was “almost clear,” with a HESI of 16 out of 360. Another case report describes 3 patients with severe, chronic, recalcitrant hand eczema demonstrating substantial responses to dupilumab, ranging from 80% improvement to complete clearance [4]. While there are two publications of patients demonstrating improvement in hand dermatitis with dupilumab, a systemic review of patients with and without hand dermatitis has not yet been done.…”

mentioning

confidence: 99%