Delgocitinib Sustains Quality of Life Gains Through 52 Weeks in Chronic Hand Eczema

Quality of life and work productivity improvements seen after 16 weeks of twice-daily delgocitinib cream 20 mg/g were sustained through 52 weeks of treatment in patients with moderate to severe chronic hand eczema (CHE), according to results from the phase 3 open-label extension DELTA 3 trial presented at the American Academy of Dermatology Annual Meeting in Denver.¹

The findings address a clinically meaningful question for dermatologists managing this difficult-to-treat population: whether early gains in patient-reported outcomes hold up over time, particularly when treatment intensity shifts from a fixed twice-daily regimen to an as-needed approach guided by disease activity.

Trial Design and Patient Population

DELTA 3 (NCT04949841) enrolled patients who had completed the delgocitinib arm of the DELTA 1 or DELTA 2 phase 3 trials, extending their total treatment exposure to 52 weeks — 16 weeks of continuous twice-daily treatment in the parent trials followed by 36 weeks of as-needed dosing in DELTA 3.² Treatment decisions in the extension phase were guided by IGA-CHE scores. Of the 560 participants who transitioned from DELTA 1 and 2, 472 completed the full 52-week assessment and were designated treatment completers. Baseline characteristics were comparable between completers and the total study population, with a mean CHE duration of approximately 9.6 years and mean baseline DLQI and HEIS scores consistent with substantial disease burden.

HRQoL Outcomes Through 52 Weeks

Improvements across all three HRQoL instruments — the CHE-specific Hand Eczema Impact Scale (HEIS), the Dermatology Life Quality Index (DLQI), and the generic EQ-5D-5L — were established during the parent trials and maintained throughout the DELTA 3 extension period.

Among treatment completers, mean HEIS total score improved from 2.49 at baseline to 0.81 at week 52, representing a mean change of −1.66 (95% CI: −1.75, −1.57; p<0.0001) — well exceeding the established minimum clinically important difference (MCID) of ≥1.3 points. Mean DLQI fell from 12.6 at baseline to 3.9 at week 52, a change of −8.5 (95% CI: −9.1, −7.9; p<0.0001), again surpassing the MCID threshold of ≥4 points. EQ-5D-5L index scores improved by a mean of 0.20 (95% CI: 0.18, 0.22; p<0.0001) over the same period. Improvements were observed across all HEIS and DLQI subdomains, including physical functioning, sleep, work, daily activities, and symptoms and feelings.

Work Productivity and Activity Impairment

The DELTA 3 data also capture the impact of sustained treatment on occupational functioning — an area of particular relevance given that CHE disproportionately affects the working-age population and is a leading cause of occupational skin disease. Using the Work Productivity and Activity Impairment instrument adapted for CHE (WPAI:CHE), investigators found that mean work productivity loss dropped from 44.3% at baseline to 19.0% at week 52, a change of −25.4 percentage points among completers (p<0.0001). Presenteeism and daily activity impairment showed similarly significant and sustained reductions.

Notably, a subgroup of patients who reported absenteeism greater than zero at baseline — reflecting more severe functional impairment at the outset — demonstrated even larger gains across all WPAI:CHE domains. In this subgroup, work productivity loss fell from 69.1% at baseline to 26.4% at week 52, a mean reduction of −41.5 percentage points (p<0.0001). Absenteeism itself showed a statistically significant improvement only within this higher-burden subgroup, with a mean change of −15.4 percentage points (p=0.0002), while the overall population did not reach significance for that specific endpoint — an expected finding given that most patients had minimal absenteeism at baseline.

Clinical Implications

Taken together, these data suggest that the benefits of delgocitinib cream extend well beyond the initial treatment window and are durable under a more flexible, real-world-aligned dosing approach. For a chronic, relapsing disease like CHE that imposes significant functional and psychosocial burden on patients, the ability to maintain meaningful HRQoL improvements with as-needed treatment represents a clinically relevant advantage. The consistent findings across disease-specific, dermatology-specific, and generic outcome measures further strengthen confidence in the breadth of benefit observed.

References

1. Armstrong AW, Stein Gold L, Bauer A, Greig J, Norlin JM, Thoning H, Agner T. Sustained health-related quality of life improvements with delgocitinib 20 mg/g cream in chronic hand eczema – results from the phase 3 open-label extension DELTA 3 trial. Poster presented at the 2026 American Academy of Dermatology Annual Meeting. Denver, Colorado. March 27-31, 2026. https://eposters.aad.org/s3/AM2026/poster/72213/Sustained+Health-Related+Quality+of+Life+and+work+productivity+improvements+with+Delgocitinib+20+mgg+Cream+in+Chronic+Hand+Eczema+-+Results+from+the+Phase+3+Open-Label+Extension+DELTA+3+Trial.pdf
2. Bissonnette R, Warren RB, Pinter A, et al. Efficacy and safety of delgocitinib cream in adults with moderate to severe chronic hand eczema (DELTA 1 and DELTA 2): results from multicentre, randomised, controlled, double-blind, phase 3 trials. Lancet. 2024;404(10451):461-473. doi:10.1016/S0140-6736(24)01027-4