Chronic hand eczema in Germany: 5-year follow-up data from the CARPE registry

2018 ◽  
Vol 80 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Christian J. Apfelbacher ◽  
Robert F. Ofenloch ◽  
Elke Weisshaar ◽  
Sonja Molin ◽  
Andrea Bauer ◽  
...  
Keyword(s):  
Hand Eczema ◽  
Chronic Hand Eczema

scholarly journals Alitretinoin for the treatment of severe chronic hand eczema

2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. 39-45
Author(s):  
M Paulden ◽  
M Rodgers ◽  
S Griffin ◽  
R Slack ◽  
S Duffy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Supportive Care ◽  
Time Horizon ◽  
Hand Eczema ◽  
Decision Analytic Model ◽  
Topical Steroids ◽  
Analytic Model ◽  
Chronic Hand Eczema ◽  
The Impact

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of alitretinoin for the treatment of adults with severe chronic hand eczema refractory to topical steroid treatment in accordance with the licensed indication, based upon the evidence submission from Basilea Pharmaceuticals Ltd to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The clinical evidence came from a single placebo-controlled randomised controlled trial of daily treatment with alitretinoin for 12–24 weeks, with follow-up for a further 24 weeks, in patients with severe chronic hand eczema (CHE) unresponsive to topical steroids. A statistically significantly greater proportion of patients using alitretinoin achieved the primary end point of clear or almost clear hands by week 24 than did those with placebo. Dose-dependent headache was the most commonly reported adverse event in patients treated with alitretinoin. Serious adverse events were rare, but alitretinoin was associated with increases in both total cholesterol and triglycerides, which has implications for risks of future cardiovascular events. The manufacturer submitted a de novo decision analytic model to estimate, over a time horizon of 3 years, the cost-effectiveness of alitretinoin versus the other relevant comparators identified by NICE. In response to the points of clarification put to it by the ERG regarding the initial submission, the manufacturer provided additional evidence and a revised decision analytic model with a ‘placebo’ arm. In the manufacturer’s original submission to NICE, the base-case incremental cost-effectiveness ratios (ICERs) reported for alitretinoin were £8614 per quality-adjusted life-year (QALY) versus ciclosporin, –£469 per QALY versus psoralen + UVA (with alitretinoin dominant) and £10,612 per QALY versus azathioprine. These ICERs decreased as the time horizon was extended in sensitivity analyses. In patients with hyperkeratotic CHE and in women of child-bearing potential, the ICER remained below £20,000. When the health-related quality of life (HRQoL) values used in the model were replaced with those derived from an alternative study, these ICERs increased significantly (to £22,312 per QALY for alitretinoin versus azathioprine). In the revised model, alitretinoin was reported to have an ICER of £12,931 per QALY gained versus supportive care (placebo). However, the model underestimates the costs of treatment associated with alitretinoin. The manufacturer assumed that patients receiving alitretinoin visited the dermatologist every 4 weeks and ceased treatment as soon as they responded to it. If, in practice, patients would receive treatment for longer than this, then the manufacturer’s model will have significantly underestimated the costs to the NHS. Additional analyses undertaken by the ERG produced ICERs close to £30,000 per QALY gained for alitretinoin versus supportive care. This was largely due to uncertainty surrounding the impact of alitretinoin on HRQoL. The placebo-controlled trials conducted to date have established that alitretinoin can be efficacious for the treatment of severe CHE refractory to topical steroids, but longer term follow-up of trials or the implementation of registries is required to better establish the longer term efficacy or safety of alitretinoin. NICE recommended the use of alitretinoin for patients with severe CHE and a Dermatology Life Quality Index (DLQI) score of at least 15. Treatment was recommended to be stopped as soon as an adequate response was observed, or if CHE remained severe at 12 weeks, or if response was inadequate at 24 weeks.

Hand eczema patients’ knowledge of skin protection following a guided talk—A retrospective study with a follow‐up questionnaire

2019 ◽  
Vol 81 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Yasemin Topal ◽  
Tove Agner ◽  
Janique van der Heiden ◽  
Niels E. Ebbehøj ◽  
Kim K. B. Clemmensen
Keyword(s):  
Retrospective Study ◽  
Hand Eczema ◽  
Skin Protection

FS02.5
Nickel allergy and hand eczema - a twenty-year follow-up

2008 ◽  
Vol 50 (3) ◽  
pp. 131-131
Author(s):  
Anna Josefson ◽  
G Färm ◽  
B Meding
Keyword(s):  
Hand Eczema ◽  
Nickel Allergy

Hand eczema - prognosis and consequences: a 7-year follow-up study

2014 ◽  
Vol 171 (6) ◽  
pp. 1428-1433 ◽  
Author(s):  
A.H. Petersen ◽  
J.D. Johansen ◽  
M. Hald
Keyword(s):  
Hand Eczema ◽  
Follow Up Study

scholarly journals Skin Microbiome in Patients with Hand Eczema and Healthy Controls: A Three-week Prospective Study

2021 ◽  
Author(s):  
Line Brok Nørreslet ◽  
Berit Lilje ◽  
Anna Cäcilia Ingham ◽  
Sofie Marie Edslev ◽  
Maja-Lisa Clausen ◽  
...  
Keyword(s):  
Prospective Study ◽  
Disease Severity ◽  
Amplicon Sequencing ◽  
Hand Eczema ◽  
Skin Microbiome ◽  
Healthy Controls ◽  
16S Rrna Amplicon Sequencing ◽  
Chronic Hand Eczema ◽  
Α Diversity ◽  
Underlying Mechanisms

The pathogenesis of chronic hand eczema remains unclear. Insights into the skin microbiome in hand eczema and its potential relevance to disease severity may help to elucidate the underlying mechanisms of hand eczema. The aim of this study was to characterize the microbiome in patients with hand eczema and healthy controls. A 5-visit prospective study was conducted over a period of 3 weeks. At each visit, bacterial swabs were taken from the hands of patients with hand eczema and controls. The microbiome was examined using DNA extraction and 16S rRNA amplicon sequencing (V3–V4 regions). Fifty patients with hand eczema and 50 controls were included (follow-up rate=100%). The baseline bacterial α-diversity was reduced on the hands of patients with hand eczema compared with controls (effect size=–0.31; 95% confidence interval (95% CI) –0.50; –0.11; p = 0.003). The dysbiosis on the patients’ hands was stable over the study period, was associated with disease severity, and was characterized by reduced bacterial diversity and different bacterial community compositions.

scholarly journals Drugs for the Treatment of Chronic Hand Eczema: Successes and Key Challenges [Corrigendum]

2021 ◽  
Vol Volume 17 ◽  
pp. 233-234
Author(s):  
Celina Dubin ◽  
Ester Del Duca ◽  
Emma Guttman-Yassky
Keyword(s):  
Hand Eczema ◽  
Chronic Hand Eczema
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