Evaluating Topical Ruxolitinib Cream for Chronic Hand Eczema

In a multicenter, randomized, double-blind study, ruxolitinib cream produced significantly greater symptom improvement than vehicle by week 16 in adults with moderate-to-severe nonatopic chronic hand eczema.

The trial randomized 186 adults with moderate-to-severe chronic hand eczema without current atopic dermatitis or a recent history of atopic dermatitis. The prespecified primary endpoint was investigator global assessment-chronic hand eczema treatment success (IGA-CHE-TS), defined as an IGA-CHE score of 0 or 1 with a ≥2-grade improvement from baseline. Participants applied ruxolitinib 1.5% cream twice daily.

At week 16, 53.2% of patients treated with ruxolitinib cream achieved the prespecified IGA-CHE-TS endpoint versus 10.9% with vehicle (P < .0001). Reductions in itch, measured by the Itch Numeric Rating Scale, were significantly greater with ruxolitinib at multiple time points. Improvements in additional validated severity and quality-of-life measures were observed, with secondary and subgroup analyses supportive but exploratory.

Most treatment-emergent adverse events were mild or moderate and occurred at similar frequencies in the ruxolitinib and vehicle groups. Application-site reactions were uncommon. Rates of serious adverse events and treatment discontinuations were low and comparable between groups, and no clinically meaningful laboratory abnormalities or new safety signals were identified during the study.

Ruxolitinib cream’s nonsteroidal mechanism would provide an alternative to topical corticosteroids and other topical agents.