Tens of thousands of adults in England suffering from painful, debilitating hand eczema are set to benefit from a pioneering new treatment, delgocitinib, which has today been approved by the NHS. Sold under the brand name Anzupgo, this twice-daily cream offers hope for individuals affected by moderate to severe chronic hand eczema, a severe inflammatory condition characterized by itchy, cracked, and dry patches of skin.

The cream works by specifically targeting proteins known as Janus kinases, which drive the inflammation associated with eczema. Its effectiveness was first recognized last year by the UK’s medicines watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA), which granted approval. Following this, the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), officially endorsed the treatment, making it available for prescription in England. Delgocitinib was also approved for use in the European Union last year, highlighting its international recognition.

Clinical studies involving 960 adults with moderate to severe chronic hand eczema demonstrated the superior efficacy of delgocitinib compared to a placebo. One study showed that around 20% of patients treated with the cream experienced most or all of their chronic hand eczema clearing up, significantly higher than the approximately 10% of those using a placebo. A second study reported even more promising results, with 29% of patients on delgocitinib achieving clearance, compared to just 7% in the placebo group. Compared to traditional treatments, delgocitinib was able to completely clear rashes in almost a third of patients, a marked improvement over the mere 7% achieved with conventional approaches.

Delgocitinib is intended as an option for patients with limited alternatives, particularly when steroid creams have proven ineffective or are unsuitable. It is applied at home to affected areas on the hands and wrists. This new therapeutic avenue provides a much-needed alternative to treatments such as ultraviolet (UV) light therapy, which requires frequent hospital visits, or retinoid capsules, which can cause side effects including dizziness, dry eyes, dry mouth, hair loss, anaemia, and conjunctivitis. NICE described the cream as a potential game-changer, stating it "could transform the lives of people with this debilitating condition and potentially save the NHS millions at the same time."

The treatment is expected to be available on the NHS within 90 days, providing relief to more than 62,000 people in England. Eczema, a broad group of inflammatory skin conditions, can affect up to 25% of the population. Chronic hand eczema can escalate to a debilitating state, causing intense inflammation, burning sensations, and sometimes requiring affected areas to be wrapped in bandages. Beyond the physical discomfort, it can lead to significant stress and depression, posing particular challenges for individuals working outdoors or in healthcare professions that demand frequent handwashing. While at least one in ten children experience eczema, most typically outgrow it as their immune system matures. Eczema is often linked to a common genetic mutation resulting in very dry skin, with flare-ups frequently triggered by allergies, soaps, or certain foods.