Efficacy and Safety of Alitretinoin Therapy in Korean Elderly Patients with Chronic Hand Eczema: A Retrospective Single Center Study
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Background: Chronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that alitretinoin is an effective and well-tolerated treatment for CHE. However, there is a relative lack of data on the effectiveness of alitretinoin in elderly patients. Objective: The aim of this study was to investigate the efficacy and safety of oral alitretinoin in elderly patients with moderate to severe CHE in Korea. Methods: We retrospectively investigated 46 CHE patients who were treated with either 10 mg or 30 mg of alitretinoin between June of 2016 and July of 2018. The physician’s global assessment (PGA) was used to evaluate treatment efficacy. All adverse events were retrospectively evaluated with respect to laboratory testing, including complete blood cell count, fasting blood chemistry, lipid profile, and liver and thyroid function tests. Results: The mean patient age in this study was 71.0±5.1 years. The treatment period was over eight weeks. A total of 38 of 46 patients (82.6%) exhibited clinical improvement with PGA ratings of ‘clear’ or ‘almost clear.’ There were 13 patients (28.3%) who experienced an adverse effect, with the most common being headache (13.0%) and gastrointestinal symptoms (8.7%) followed by xerosis (6.5%). A total of 13 patients developed or exhibited worsening hypertriglyceridemia (28.3%). Conclusion: Alitretinoin can be considered a safe and effective treatment option in elderly patients with moderate to severe CHE.
Abstract
Background: Chronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that alitretinoin is an effective and well-tolerated treatment for CHE. However, there is a relative lack of data on the effectiveness of alitretinoin in elderly patients. Objective: The aim of this study was to investigate the efficacy and safety of oral alitretinoin in elderly patients with moderate to severe CHE in Korea. Methods: We retrospectively investigated 46 CHE patients who were treated with either 10 mg or 30 mg of alitretinoin between June of 2016 and July of 2018. The physician’s global assessment (PGA) was used to evaluate treatment efficacy. All adverse events were retrospectively evaluated with respect to laboratory testing, including complete blood cell count, fasting blood chemistry, lipid profile, and liver and thyroid function tests. Results: The mean patient age in this study was 71.0±5.1 years. The treatment period was over eight weeks. A total of 38 of 46 patients (82.6%) exhibited clinical improvement with PGA ratings of ‘clear’ or ‘almost clear.’ There were 13 patients (28.3%) who experienced an adverse effect, with the most common being headache (13.0%) and gastrointestinal symptoms (8.7%) followed by xerosis (6.5%). A total of 13 patients developed or exhibited worsening hypertriglyceridemia (28.3%). Conclusion: Alitretinoin can be considered a safe and effective treatment option in elderly patients with moderate to severe CHE.
참고문헌 (20)
- Van Coevorden AM, "Overview of studies of treatments for hand eczema-the EDEN hand eczema survey", Br J Dermatol, 151, pp.446~451 (2004)
- Thyssen JP, "The epidemiology of hand eczema in the general population--prevalence and main findings", Contact Dermatitis, 62, pp.75~87 (2010)
- Diepgen TL, "Management of chronic hand eczema", Contact Dermatitis, 57, pp.203~210 (2007)
- Ruzicka T, "Efficacy and safety of oral alitretinoin(9-cis retinoic acid)in patients with severe chronic hand eczema refractory to topical corticosteroids : results of a randomized, double-blind, placebo-controlled, multicentre trial", Br J Dermatol, 158, pp.808~817 (2008)
- King T, "Alitretinoin for the treatment of severe chronic hand eczema", Patient Prefer Adherence, 8, pp.1629~1634 (2014)
- Ruzicka T, "Oral alitretinoin(9-cis-retinoic acid)therapy for chronic hand dermatitis in patients refractory to standard therapy : results of a randomized, doubleblind, placebo-controlled, multicenter trial", Arch Dermatol, 140, pp.1453~1459 (2004)
- Prakash AV, "Contact dermatitis in older adults : a review of the literature", Am J Clin Dermatol, 11, pp.373~381 (2010)
- Politiek K, "Alitretinoin and acitretin in severe chronic hand eczema;results from a retrospective daily practice study", Dermatol Ther, 29, pp.364~371 (2016)
- 권형일, "Efficacy and Safety of Alitretinoin for Chronic Hand Eczema in Korean Patients", Annals of Dermatology, 28(3), pp.364~370 (2016), 대한피부과학회
- Fowler JF, "A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of alitretinoin(BAL4079)in the treatment of severe chronic hand eczema refractory to potent topical corticosteroid therapy", J Drugs Dermatol, 13, pp.1198~1204 (2014)
- Dirschka T, "An open-label study assessing the safety and efficacy of alitretinoin in patients with severe chronic hand eczema unresponsive to topical corticosteroids", Clin Exp Dermatol, 36, pp.149~154 (2011)
- Bissonnette R, "Successful retreatment with alitretinoin in patients with relapsed chronic hand eczema", Br J Dermatol, 162, pp.420~426 (2010)
- "Hypertriglyceridemia" (2019)[URL]
- Diepgen TL, "Guideline on the management of hand eczema ICD-10Code: L20. L23. L24. L25. L30", J Dtsch Dermatol Ges, (7 Suppl 3), pp.S1~S16 (2009)
- Al-Dhubaibi MS, "The effectiveness of alitretinoin for the treatment of chronic hand eczema: a meta-analysis", Int J Health Sci (Qassim), 12, pp.70~79 (2018)
- Schmitt-Hoffmann AH, "Oral alitretinoin : a review of the clinical pharmacokinetics and pharmacodynamics", Expert Rev Clin Pharmacol, 5, pp.373~388 (2012)
- Krejci-Manwaring J, "Adherence with topical treatment is poor compared with adherence with oral agents:implications for effective clinical use of topical agents", J Am Acad Dermatol, (5 Suppl), pp.S235~S236 (2006)
- Tanei R, "Atopic dermatitis in the elderly", Inflamm Allergy Drug Targets, 8, pp.398~404 (2009)
- Schmith GD, "Use of longitudinal dose-response modeling to support the efficacy and tolerability of alitretinoin in severe refractory chronic hand eczema(CHE)", CPT Pharmacometrics Syst Pharmacol, 4, pp.255~262 (2015)
- Pesante-Pinto JL, "Clinical pharmacology and the risks of polypharmacy in the geriatric patient", Phys Med Rehabil Clin N Am, 28, pp.739~746 (2017)
