At the recent European Academy of Dermatology and Venereology Congress held in Amsterdam, researchers presented new insights into the significant burden of chronic hand eczema (CHE) on patients’ lives. The findings, drawn from exit interviews conducted as part of the DELTA 1 clinical trial (NCT04871711), reveal the profound effect of CHE on day-to-day activities, emotional well-being, and social interactions. The study aimed to assess the real-world impact of the condition from the perspective of those who live with it.
The DELTA 1 phase 3 trial evaluated the efficacy of delgocitinib cream, a first-in-class topical JAK inhibitor, in patients with moderate to severe CHE. Patients applied the cream twice daily (20 mg/g) for 16 weeks, with promising results: the treatment was well tolerated and showed superior efficacy compared to a cream vehicle. In October, Germany became the first country to launch delgocitinib for commercial use by LEO Pharma.
The study involved 27 patients from Canada (n=16) and the UK (n=11), who participated in semi-structured interviews within two weeks of completing the trial. The average age of participants was 43.5 years, with 66.7% identifying as female and 81.5% as white. Two-thirds of participants presented with moderate CHE at the start of the study. The most common symptoms reported included dryness, itchiness, erythema, and flaking, with cracking being the most prevalent (92.6%), often leading to pain and bleeding.
The interviews were designed to explore the patients’ experiences with symptoms and their overall impact on daily life before and during the trial. Responses were categorized into six health-related quality of life areas, and artificial intelligence software was used to analyze the interview transcripts.
The interviews revealed the extensive toll that CHE takes on patients’ quality of life. Nearly all participants (96.3%) reported that the condition negatively impacted their daily activities, including routine tasks such as handwashing, chores, and avoiding harsh soaps and chemicals.
Emotionally, 88.9% of patients reported struggling with feelings of frustration, embarrassment, and depression. One patient explained, “I always kind of hid my hands… It’s not really pleasant for people to be looking at it, and it made me very paranoid.” Another participant shared, “I think it’s affected my self-esteem… I have these hands that look about 20 years older than the rest of my body.”
Workplace difficulties were also common, with 84% of patients reporting challenges with tasks such as typing, writing, and manual labor. Furthermore, 44% indicated they had missed work due to their symptoms.
The physical limitations of CHE were stark, with 70.4% of participants struggling with basic physical tasks, such as gripping and holding objects. Sleep disturbances were another frequent issue, with 63% of patients reporting that their symptoms disrupted their sleep, particularly waking up in pain during the night.
Social functioning was similarly impacted. Over half of the participants (55.6%) noted that their condition affected their social interactions, including intimate relationships and family dynamics. One patient recalled, “During the times my hands were really bad, we had a new grandchild, and my hands were so rough that I couldn’t touch her face.”
Another participant spoke about the strain on their relationship: “We don’t cuddle on the sofa because it makes my skin prickly. Handholding is pretty much out. I know that affects my wife definitely, as well as myself.”
The findings from this study highlight the significant burden that moderate to severe CHE places on patients. Beyond the physical symptoms, the emotional, social, and professional consequences are profound. Researchers confirmed that CHE severely impacts emotional well-being, social functioning, and daily physical activities, underscoring the need for effective treatments that address not only the physical aspects of the condition but also its broader impact on quality of life.
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