26. August 2009 17:13
The National Institute for Health and Clinical Excellence (NICE) has recommended Toctino (alitretinoin) from Basilea as a cost-effective treatment option for adults with severe chronic hand eczema that has not responded to potent steroid creams.
Alitretinoin, a once-daily capsule, is the first licensed treatment for people with this condition and the only treatment proven in trials to be effective and well tolerated.
Professor Peter Littlejohns, Clinical and Public Health Director at NICE, said: “Eczema can have a huge impact on an individual, with the condition causing significant discomfort and in severe cases it can be painful. Scaling, blisters, redness and cracks in the skin are all common symptoms. Severe chronic hand eczema can affect a person’s ability to use their hands, as well as potentially impacting on work and social aspects of their lives.
“This new guidance recommending alitretinoin will offer hope to adults whose severe chronic hand eczema hasn’t been helped by strong topical corticosteroids.”
In the largest-ever Phase III clinical trial programme in chronic hand eczema, alitretinoin was the first treatment able to show effective clearing of severe chronic hand eczema unresponsive to potent topical corticosteroids, with clear or almost clear hands achieved in nearly 50% of patients treated with 30mg alitretinoin.
“The National Eczema Society welcomes the decision from NICE to recommend the use of alitretinoin for people with chronic hand eczema, which is a complex and difficult condition to treat,” said Margaret Cox, Chief Executive of the National Eczema Society. “People who have chronic hand eczema are severely disadvantaged since they are unable to use their hands normally. This may force people to take sick leave and even to give up their jobs completely in addition to restricting normal household and leisure activities.”
The NICE guidance also recommends that only dermatologists, or physicians with experience in both managing severe chronic hand eczema and the use of systemic retinoids, should start and monitor treatment with alitretinoin.