New Drug Relieves Hand Eczema

9 Mar, 2010 in Health and Pharmacy News by admin

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In Some Patients, Alitretinoin Cleared Very bad
Hand Eczema After Standard Treatment Failed

By Charlene Laino
WebMD Health News
Reviewed by Laura J. Martin, MD

March 8, 2010 (Miami Beach, Fla.) — A recent drug called alitretinoin can help
relieve cracked, itchy, irritated hands in people with very bad
hand eczema,
researchers report.

Hands "completely or almost completely" cleared up in nearly half of people
with hand eczema that didn’t respond to standard treatment, says Charles Lynde,
MD, assistant professor of dermatology at the University of Toronto.

Up to 10% of people possess hand dermatitis, in which the skin becomes inflamed,
typically from an allergic reaction to an irritant, Lynde says. The hand becomes
dry as well as chapped as well as eventually red, scaly, as well as inflamed.

Of those, about 5% possess dermatitis as very bad as the people in the recent
research, he says.

"These were hard-core patients who weren’t getting best when treated with
ointments containing corticosteroids," the standard drugs used to lower
inflammation in people with very bad dermatitis. They had suffered for nine or 10
years, on average, Lynde tells WebMD.

"At existing, we don’t possess very much to offer when corticosteroid [ointments]
fail," he says.

Enter alitretinoin, a relative of vitamin A that is approved for very bad hand
eczema in some European countries as well as Canada but not the U.S. It’s given in
capsule form, daily.

At the annual meeting of the American Academy of Dermatology (AAD), Lynde
summarized findings from three studies showing that alitretinoin is effective in
a substantial proportion of these patients.

"The earliest as well as subordinate studies show that itching, redness, fissures, as well as
dryness go away. The third shows it will help incase you relapse," he says.

The research was funded by Basilea Pharmaceutica International, which markets
alitretinoin under the brand name Toctino in Europe. Lynde has reported being a
consultant for Basilea.

Alitretinoin Clears Up Very bad Hand Dermatitis

The largest of the studies involved 1,032 people with very bad hand dermatitis
in Europe as well as Canada. The patients took a 10-milligram or 30-milligram dose of
alitretinoin, or placebo, daily for 12 or 24 weeks.

Participants were told to avoid irritants such as detergent that could
trigger or exacerbate their dermatitis.

The skin condition completely or almost completely resolved in 48% of
patients treated with the higher dose of alitretinoin. "That means they were
90%, 95%, 100% improved," Lynde says.

In contrast, 28% of patients treated with the lower dose as well as 17% of
placebo-treated patients completely or almost completely responded.

The subordinate study involved 249 patients in Europe as well as Canada. All had suffered
from hand eczema for years. Steroid ointments no longer worked for them, Lynde
says.

All received the higher dose of alitretinoin for up to 24 weeks.

The hand rash cleared up in 47% of patients.

The third study was designed to determine incase the drug could help patients who
relapse after treatment with alitretinoin.

"About a third relapsed, so we tried alitretinoin again," Lynde says.

It worked, with the rash resolving in about four-fifths of patients given the
30-milligram dose. In contrast, fewer than 10% of patients given a placebo
responded.

Alitretinoin doesn’t work overnight — it typically takes four to six weeks
to see any change, Lynde says. As well as not everyone responds.

"But this does offer recent hope for dermatitis we thought was incurable.
Patients improve as well as quite a few go into remission," he says.

The most repeated side effects are headache as well as dryness as well as flushing of the
skin, Lynde says. As well as, it can cause humorless, even fatal birth defects, so
women
who are pregnant or thinking about getting pregnant should never take it, he
says.

Additionally, the medication can make you more sensitive to the sun, so you
may burn more easily, says done AAD president Darrell S. Rigel, MD, clinical
professor of dermatology at New York University Health examination Center.

"On the flip side, chronic hand eczema is very rocklike to treat. Incase it’s so
severe you don’t want to go out in community or you’re in business as well as don’t want
to shake hands, this appears to offer a pleasant option," he tells WebMD.

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