Dupilumab for Chronic Hand Eczema: A Systematic Review and Meta-Analysis

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• Chronic hand eczema (CHE) is a prevalent and challenging dermatologic condition.
• Dupilumab, an IL-4/13 inhibitor, has demonstrated efficacy in atopic dermatitis (AD) and is being investigated for CHE.

Purpose of the Study:

• To evaluate the therapeutic efficacy of dupilumab in treating chronic hand eczema (CHE).
• To assess dupilumab's effectiveness across various CHE subtypes and patient populations.

Main Methods:

• A systematic literature search was conducted on the PubMed database using terms related to dupilumab and chronic hand eczema.
• Twenty-two publications, including clinical trials, observational studies, case series, and case reports involving 374 patients, were analyzed.
• Data on treatment response, efficacy in different CHE subtypes, quality of life, and adverse events were extracted and evaluated.

Main Results:

• Dupilumab treatment resulted in partial or complete resolution of CHE in 80.3% of patients within 4-16 weeks.
• Significant improvements were observed in hand eczema severity and quality-of-life scores.
• Efficacy varied among CHE subtypes, with higher response rates in dyshidrotic, vesicular, atopic, and contact CHE compared to hyperkeratotic CHE.

Conclusions:

• Dupilumab demonstrates significant therapeutic efficacy for chronic hand eczema (CHE).
• Patients with a history of atopic dermatitis (AD) showed enhanced improvement with dupilumab.
• Further randomized controlled studies are warranted to explore dupilumab's efficacy in specific CHE subtypes.