New topical JAK inhibitor available for treating chronic hand eczema

Leo Pharma is introducing Anzupgo (delgocitinib 20 mg/g topical cream; 60 g tube) for the treatment of moderate to severe chronic hand eczema in adults. The product is intended to be used when topical corticosteroids are inadequate or inadvisable.1 Delgocitinib is a Janus kinase (JAK) inhibitor. It inhibits the activation of JAK-STAT signalling, which plays a key role in the pathogenesis of chronic hand eczema. Delgocitinib attenuates the signalling of several pro-inflammatory cytokines (including several interleukins, granulocyte-macrophage-colony-stimulating factor [GM-CSF] and interferon-α), which downregulates the immune and inflammatory responses in cells involved in the pathology of chronic hand eczema.1Delgocitinib cream should be applied to the affected skin of the hands and wrists twice daily (about 12 hours apart), until the skin is clear or almost clear. The cream should be discontinued when the signs and symptoms of chronic hand eczema resolve. If flares occur, twice daily treatment of the affected areas should be restarted as needed. Therapy should be re-evaluated if signs and symptoms do not improve within 12 weeks of treatment. Advise patients not to use more than one 60 g tube per month.1Instruct patients to apply a thin layer of cream to clean and dry skin of the affected areas of the hands and wrists. Warn them to avoid contact with the eyes, mouth or other mucous membranes; if such contact occurs, advise to rinse thoroughly with water. Application of other topical products should be avoided within two hours before and after application of delgocitinib cream. Co-application with emollients within two hours before and after application of delgocitinib has not been studied.1Application site reactions (i.e., application site pain, paresthesia, pruritus, erythema) are the most common adverse effects of delgocitinib cream. Nonmelanoma skin cancer has been reported in patients treated with topical JAK inhibitors; an application site skin examination should be considered before starting delgocitinib and periodically during treatment in patients with a history of skin cancer or those with risk factors for skin cancer.1Topical delgocitinib has a low potential for interaction with systemic medications due to limited metabolism of delgocitinib, application to a limited body surface area (handsand wrists only), and low systemic exposure of topically applied delgocitinib. The product has not been evaluated in combination with other topical medications; co-application to the same skin area is not recommended. It also has not been studied in combination with other treatments for chronic hand eczema (e.g., oral alitretinoin). Use in combination with other JAK inhibitors, immunomodulators or potent immunosuppressants has not been studied; such combinations should be used with caution.1Anzupgo (delgocitinib topical cream) should be stored below 30°C. Instruct patients to use the tube within 12 months of first opening and not to use past the expiry date.1Delgocitinib topical cream is the first topical JAK inhibitor to be specifically approved for treatment of adults with moderate to severe chronic hand eczema when topical corticosteroids are inadequate or inadvisable. Another topical JAK inhibitor—ruxolitinib 1.5% cream (Opzelura)—is indicated for topical treatment of mild to moderate atopic dermatitis in patients two years of age or older whose disease is not adequately controlled with conventional topical prescription therapies (topical corticosteroids, topical calcineurin inhibitors) or when those therapies are not advisable. It can be used on the hands, as well as on other affected areas of skin.2Hand eczema is a common inflammatory skin disorder. Patients may experience a high degree of itching, as well as pain, erythema, edema, scaling, vesicles, hyperkeratosis, fissures and lichenification. Risk factors include a history of atopic dermatitis, contact allergies and exposure to “wet work” (e.g., healthcare workers, food handlers, hairdressers). Hand eczema is considered chronic if it persists for longer than three months or if there are two or more relapses per year.3Preventive measures for hand eczema include avoidance of irritants and use of protective gloves. Emollients and moisturizers are recommended for all patients.3Topical corticosteroids are generally first-line therapy. High-potency topical corticosteroids may be needed to achieve disease control, but their use is limited by serious adverse effects (e.g., skin atrophy) with long-term use. Tacrolimus (Protopic), a topical calcineurin inhibitor, has been used for treatment of chronic hand eczema when there is an inadequate response to topical corticosteroids or to minimize corticosteroid use. It does not cause skin atrophy.3,4Medical Letter consultants indicate that delgocitinib cream was shown in two 16-week clinical trials to be more effective than its vehicle alone for treatment of moderate to severe chronic hand eczema in patients who had an inadequate response to or were unable to use topical corticosteroids. However, they comment that the cream is expensive and how it compares to the use of topical tacrolimus is unknown.3References:Leo Pharma Inc. Anzupgo (delgocitinib topical cream) product monograph. Toronto, ON; August 25, 2025. (accessed October 21, 2025).Incyte Corp. Opzelura (ruxolitinib cream) product monograph. Wilmington, DE; October 9, 2025. (accessed October 21, 2025).Anon. Delgocitinib cream (Anzupgo) for chronic hand eczema. Med Lett Drugs Ther 2025;67:163-5.Leo Pharma Inc. Protopic (tacrolimus 0.03% and 0.1% ointment) product monograph. Toronto, ON; August 13, 2021. (accessed October 21, 2025).

New topical JAK inhibitor available for treating chronic hand eczema

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