NICE has issued preliminary guidance on the use of the drug alitretinoin for the treatment of severe chronic hand eczema in adults.
Alitretinoin is the first licensed treatment for chronic hand eczema in the UK. The preliminary recommendations from NICE state that only patients with severe disease, who are unresponsive to potent topical corticosteroids, should receive the once-daily drug, and only if the condition has not responded to prior treatment with oral immunosupressants or phototherapy.
John English, consultant dermatologist at Queen’s Medical Centre in Nottingham, said: ‘This preliminary recommendation from NICE is a significant advance in the management of chronic hand eczema since alitretinoin offers patients the potential to clear their hands of eczema.
‘However, given that older treatments such as ciclosporin, azathioprine and PUVA are unlicensed and may have serious adverse effects, it should be the responsibility of clinicians to decide, after careful discussion with the patient, when their use is warranted in preference to a licensed therapy.’
Final NICE guidance is expected in August 2009.