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Abstract
Background: Chronic hand eczema is a common inflammatory skin condition that severely impairs quality of life due to persistent symptoms and limitations of current treatments such as topical corticosteroids prone to skin atrophy and oral alitretinoin with teratogenic risks, while topical JAK inhibitor delgocitinib has demonstrated efficacy in individual trials but lacks comprehensive comparison with other therapies. Objectives: The study aimed to evaluate the relative efficacy and safety of delgocitinib compared to other pharmacological treatments in moderate-to-severe chronic hand eczema in adults. Methods: A network meta-analysis was conducted on 11 randomized controlled trials involving 734 adult patients from major bibliographic databases and trial registries, using two separate sub-networks each comprising 5 studies, measuring the primary outcome as the rate of achieving at least 75 percent improvement in Hand Eczema Severity Index and safety as any adverse events. Results: Delgocitinib showed superior efficacy with 7.7 to 8.3 times higher likelihood of achieving at least 75 percent improvement in Hand Eczema Severity Index compared to standard care and vehicle, while reducing adverse event risk by 70 to 72 percent, whereas topical corticosteroids were 9.1 times superior to placebo but equivalent to upadacitinib in efficacy, with both increasing adverse event risk by more than 3.5 times versus placebo, with no heterogeneity or inconsistency observed despite wide confidence intervals due to limited studies. Conclusions: Delgocitinib stands out as the superior topical option for both clinical efficacy and safety profile, guiding a shift in chronic hand eczema management practice.
| Published | 2025-12-31 | |
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| Issue | Vol. 4 No. 4 (2025) | |
| Section | Original article | |
| DOI | 10.66517/jstmp.2025.4.11 | |
| Keywords | Delgocitinib, Viêm da cơ địa bàn tay mạn tính, HECSI-75, An toàn điều trị, Ức chế JAK Delgocitinib, Chronic hand eczema, Network meta-analysis, HECSI-75, Treatment safety, JAK inhibition |
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