Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial

Abstract

Alitretinoin given at well-tolerated doses induced clearing of CHE in a substantial proportion of patients with severe disease refractory to standard therapy.

Hand Eczema

“…In a randomized trial involving 1032 patients with chronic hand eczema (all types) that compared the use of 30 mg of alitretinoin daily, 10 mg of alitretinoin daily, and placebo for up to 24 weeks, the percentages of patients rating their hand eczema as "clear" or "almost clear" at the end of therapy were 40%, 24%, and 15%, respectively. 41 Patients with hyperkeratotic eczema had the highest response rates to alitretinoin, but those with vesicular eczema also appeared to benefit, although formal subgroup comparisons were not performed. The beneficial effects of alitretinoin as compared with placebo were confirmed in a retreatment trial among a subgroup of patients who had had a relapse.…”

Alitretinoin in treatment of chronic hand eczema – mechanism of action

“…-pierwsze w grupie 319 pacjentów z równie obiecującymi wynikami [26] i następne nazwane akronimem BACH (ang. Benefit of Alitretinoin in Chronic Hand Dermatitis), z udziałem 1032 pacjentów ze 111 klinik w Europie i Kanadzie [27]. Pacjenci otrzymywali lek w dawce 30 mg/dobę, 10 mg/dobę lub placebo przez okres do 24 tygodni.…”

“…modified Total Lesion Symptom Score). Stwierdzono całkowite lub prawie całko-wite ustąpienie zmian u 48% leczonych największą dawką (30 mg/dobę) w porównaniu z 28% pacjentów leczonych dawką 10 mg/dobę i 17% pacjentów z grupy otrzymujących placebo [27]. W 2009 roku przeprowadzono dodatkowe badanie oceniające skuteczność powtórnego włączenia terapii alitretynoiną u osób z nawracającym wypryskiem rąk i uzyskano obiecujące wyniki [28].…”

Alitretinoin (Toctino): new oral retinoid for chronic hand eczema

“…10 Treatment was stopped in those with a PGA rating of clear/almost clear after 12 weeks, while the others continued treatment for 24 weeks (results were not reported separately). Again, most patients had hyperkeratotic-type eczema (85 per cent), pompholyx (27 per cent) or fingertip eczema (46 per cent), but aetiology was not reported.…”