Delgocitinib can be used, within its marketing authorisation, as an option to treat moderate to severe chronic hand eczema in adults when topical corticosteroids have not worked or are not suitable. Delgocitinib can only be used if the company provides it according to the commercial arrangement.
Delgocitinib should be started and monitored by a healthcare professional with experience in diagnosing and treating chronic hand eczema in secondary care.
Consider how skin colour could affect the assessment of severity and make any adjustments needed.
What this means in practice
Delgocitinib must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Delgocitinib must be funded in England within 90 days of final publication of this guidance.
There is enough evidence to show that delgocitinib provides benefits and value for money, so it can be used routinely across the NHS in this population.
NICE has produced tools and resources to support the implementation of this guidance.
Usual treatment for moderate to severe chronic hand eczema when topical corticosteroids have not worked or are not suitable includes phototherapy (ultraviolet light therapy) or alitretinoin.
Clinical trial evidence shows that delgocitinib is more effective at improving symptoms of chronic hand eczema than alitretinoin or 'vehicle cream' (a cream that does not contain an active ingredient).
Delgocitinib has not been directly compared in a clinical trial with phototherapy, but an indirect comparison suggests that delgocitinib is more effective.
There are some uncertainties in the economic model. But the most likely cost-effectiveness estimates for using delgocitinib in secondary care are within the range that NICE considers an acceptable use of NHS resources. So, it can be used.