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European Journal of Dermatology

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Efficacy and safety of oral alitretinoin as treatment for chronic hand eczema in France: a real-life open-label study Volume 29, numéro 1, January-February 2019

Illustrations

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Auteurs
1 Institut Fournier, Dermatologie, Paris,
2 Université Paul Sabatier, CHU Toulouse, Dermatologie, Toulouse,
3 Université de la Méditerranée, Hôpital Nord, Dermatologie, Marseille,
4 Hôpital Nord, Dermatologie, Saint-Etienne,
5 Hôpital Saint-André, Dermatologie, CHU Bordeaux, Bordeaux,
6 Hôpital Charles Nicolle, Dermatologie, Rouen,
7 UniversitéAix-Marseille, UMR 911, INSERM CRO2, Dermatologie, Hôpital la Timone, Marseille,
8 GSK, Rueil Malmaison,
9 Hôpital Henri Mondor, Dermatologie, Créteil, France
* Reprints
  • Mots-clés : alitretinoin, chronic hand eczema, observational study, effectiveness, safety
  • DOI : 10.1684/ejd.2018.3484
  • Page(s) : 59-66
  • Année de parution : 2019

Background: Chronic hand eczema is an inflammatory dermatosis that results in a significant psychological and socio-economic burden. Alitretinoin (AL) is indicated in adults with severe chronic hand eczema (sCHE) unresponsive to potent topical corticosteroids. Objectives: To assess AL effectiveness and safety in patients with sCHE under real-life conditions based on a prospective observational study in France (2010-2014). Materials & Methods: Clinical severity was assessed using Physician Global Assessment (PGA) and Modified Total Lesion Symptom Score (mTLSS) and quality of life by Skindex and visual analogue scales. Patients were treated with AL for 12-24 weeks and followed for 24 months. Responders were patients with clear/almost clear skin based on PGA at the end of treatment and the primary outcome was remission (clear, almost clear, or mild skin) at one and two years after treatment. Results: A total of 394 patients with severe or moderate PGA were included in the study by 109 dermatologists. AL treatment duration was 5.4 ± 4.1 months (mean ± SD) and 112/274 patients evaluated at the end of treatment were responders. Of the 112 responders, 41/51 evaluable patients were in remission after one year and 36/46 after two years. At the end of treatment, Skindex improved from 48.8 ± 18.1% to 27.1 ± 23.2%. Among the 112 responders, 68/84 did not relapse (mTLSS increased >75% from baseline).The most common adverse events were headache (24%) and dyslipidaemia (4%). Conclusions: This study supports a positive benefit/risk profile for AL for sCHE patients unresponsive to topical corticosteroids.