Comparative Efficacy and Safety of Delgocitinib, Alitretinoin, and PUVA in Patients With Moderate-to-Severe Chronic Hand Eczema: A Network Meta-Analysis
Author(s)
Ryan Pulleyblank, PhD1, Rie von Eyben, MSc1, Daniela Goncalvez-Bradley, PhD2, Bryony Langford, MPhil, MSc2, Laura Sawyer, MSc2, Nanna Nyholm, MSc1.
1LEO Pharma A/S, Ballerup, Denmark, 2Symmetron Ltd, London, United Kingdom.
1LEO Pharma A/S, Ballerup, Denmark, 2Symmetron Ltd, London, United Kingdom.
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. This analysis investigated the relative efficacy and safety of these treatments.
METHODS: A Bayesian NMA was used to assess the relative efficacy and safety of treatments for CHE based on randomized clinical trials identified in a systematic literature review and data on file. Efficacy outcomes included the Investigator’s Global Assessment for Chronic Hand Eczema or Physician Global Assessment score of 0 or 1 (IGA-CHE/PGA) endpoint response, as well as the Hand Eczema Severity Index (HECSI) 90 endpoint response. Safety endpoints included discontinuation due to adverse events (DAEs).
RESULTS: Amongst patients with moderate or severe chronic hand eczema, delgocitinib treatment was associated with significantly higher odds of achieving IGA-CHE/PGA 0/1 clinical response at week 12 when compared with alitretinoin (median odds ratio [mOR]: 1.89; 95% credible interval [CrI]: 1.23, 2.93), and PUVA (mOR: 2.73; 95% CrI: 1.43, 5.25). Considering the HECSI-90 endpoint, delgocitinib was associated with significantly higher odds of achieving clinical response at week 12 than alitretinoin (mOR: 1.79; 95% CrI: 1.23, 2.63). The HECSI-90 endpoint was not reported for PUVA. Delgocitinib was associated with significantly lower rates of discontinuation due to adverse events when compared with alitretinoin (mOR: 0.07; 95% CrI: 0.02, 0.17) and PUVA (mOR: 0.07; 95% CrI: 0.02, 0.25).
CONCLUSIONS: 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.
METHODS: A Bayesian NMA was used to assess the relative efficacy and safety of treatments for CHE based on randomized clinical trials identified in a systematic literature review and data on file. Efficacy outcomes included the Investigator’s Global Assessment for Chronic Hand Eczema or Physician Global Assessment score of 0 or 1 (IGA-CHE/PGA) endpoint response, as well as the Hand Eczema Severity Index (HECSI) 90 endpoint response. Safety endpoints included discontinuation due to adverse events (DAEs).
RESULTS: Amongst patients with moderate or severe chronic hand eczema, delgocitinib treatment was associated with significantly higher odds of achieving IGA-CHE/PGA 0/1 clinical response at week 12 when compared with alitretinoin (median odds ratio [mOR]: 1.89; 95% credible interval [CrI]: 1.23, 2.93), and PUVA (mOR: 2.73; 95% CrI: 1.43, 5.25). Considering the HECSI-90 endpoint, delgocitinib was associated with significantly higher odds of achieving clinical response at week 12 than alitretinoin (mOR: 1.79; 95% CrI: 1.23, 2.63). The HECSI-90 endpoint was not reported for PUVA. Delgocitinib was associated with significantly lower rates of discontinuation due to adverse events when compared with alitretinoin (mOR: 0.07; 95% CrI: 0.02, 0.17) and PUVA (mOR: 0.07; 95% CrI: 0.02, 0.25).
CONCLUSIONS: 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.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO55
Topic
Clinical Outcomes, Economic Evaluation, Methodological & Statistical Research
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)