Chronic hand eczema is a type of skin disease that affects the skin on your hands and wrists. While there is no cure for chronic hand eczema, different types of medicines can be used to help manage symptoms. Medicines that you apply to your skin, called topical corticosteroids, can be used to help with this condition,but some people do not get enough help from these medicines or are not able to use these for a variety of reasons. Anzupgo (delgocitinib) was approved in 2025 as the first medicine to treat moderate to severe chronic hand eczema in adults.
How Does It Work?
A chronic condition is one that lasts for a longer period of time (months, years, or a lifetime). Your health care provider may diagnose you with chronic hand eczema if you have had chronic eczema on your hands or wrists for three months or longer or if you have had two or more cases where your chronic hand eczema has gone away, then come back within the last 12 months. People who have chronic hand eczema often have pain and itching, and the skin of their hands may be red, hardened, and cracked.
Chronic hand eczema can happen when your immune system overreacts and causes skin inflammation. There can be triggers that can turn your immune system on, such as pollen, perfumes, pets, and certain fabrics and metals. Stress and a family history of eczema can also increase your risk of developing the condition.
Anzupgo is known as a topical Janus kinase (JAK) inhibitor. Anzupgo comes as a cream that is applied to your skin. It works on your immune system to block signaling on specific proteins that cause inflammation. This can help lower symptoms of chronic hand eczema.
How Do I Use It?
Anzupgo comes as a cream in a 30-gram tube and should be applied twice a day on the affected areas of your hands and wrists. Setting reminders or alarms on your phone, or associating it with a twice-a-day habit like brushing your teeth, can help you remember to use the medicine. Do not use more than one tube of Anzupgo in a two-week period or more than two tubes in a month. Do not get Anzupgo in your eyes, mouth, vagina, or nose. If this happens, rinse the area well with water.
Before applying Anzupgo, clean and dry the affected area. If someone else is applying the medicine to you, they should wash their hands after handling the medicine. If you are breastfeeding while using Anzupgo, do not touch your nipple or breast right after using the medicine, as this can cause your baby to be exposed to the medicine.
How Was It Studied For Chronic Hand Eczema?
Two studies (DELTA 1 and DELTA 2) were done to see if Anzupgo was safe and effective. People in the studies had moderate to severe chronic hand eczema and either did not see a benefit with topical corticosteroids or were unable to use them.
People in the studies used either Anzupgo or a cream without any medicine in it (known as a vehicle). The studies looked at the number of people who achieved treatment success, which was defined as an Investigator’s Global Assessment for Chronic Hand Eczema (IGA-CHE) score of 0 (clear) or 1 (almost clear), with at least a 2-point improvement at week 16. The IGA-CHE score measures how severe your chronic hand eczema symptoms are, with the scores ranging from 0 to 4. The table below lists what each score of the IGA-CHE scale means.
Score | Investigator’s Global Assessment for Chronic Hand Eczema (IGA-CHE) |
0 | Clear |
1 | Almost clear |
2 | Mild |
3 | Moderate |
4 | Severe |
The studies also looked at the number of people who had a meaningful Hand Eczema Symptom Diary (HESD) itch score and pain score reduction, which was defined as at least a 4-point improvement. The HESD itch score measures how itchy your chronic hand eczema is, with the scores ranging from 0 (no itching) to 10 (the worst itching). The HESD pain score measures how painful your chronic hand eczema is, with the scores ranging from 0 (no pain) to 10 (the worst pain). Each day, the people in the studies reported their HESD itch score and HESD pain score, and a weekly average of those scores was calculated.
The average age of people in both studies was 44. The first study included White people (88%), Asian people (4%), Black or African American people (1%), and “other or not reported” (8%). The second study included White people (93%), Asian people (3%), Black or African American people (1%), and “other or not reported” (3%).
DELTA 3 was a study that included people who completed either DELTA 1 or DELTA 2. All the people in the study used Anzupgo twice daily as needed for 36 weeks. People who had an IGA-CHE score of 0 (clear) or 1 (almost clear) at the beginning of the study did not receive Anzupgo, but if anytime during the study their score was greater than or equal to 2, they would start using Anzupgo again. People who had an IGA-CHE score of greater than or equal to 2 at the beginning of the study used Anzupgo twice a day until they had an IGA-CHE score of 0 or 1. Once anyone reached a 0 or 1 score, the medicine was stopped.
The DELTA 3 study looked to see the number of people who had an IGA-CHE score of 0 or 1 and the number of people who had 75% or greater or 90% or greater improvement in their Hand Eczema Severity Index (HECSI-75/90) scores after using as-need Anzupgo for 36 weeks.
What Benefits Were Seen?
At 16 weeks, more people in the Anzupgo group had clear to almost clear skin compared to the people who used the vehicle. More people in the Anzupgo group also had a greater reduction in their chronic hand eczema pain and chronic hand eczema itchiness.
Below is a summary of the significant results from the DELTA 1 and 2 studies.
DELTA 1 | DELTA 2
| |||
Anzupgo | Vehicle | Anzupgo | Vehicle | |
IGA-CHE TS | 19.7% | 9.9% | 29.1% | 6.9% |
Meaningful Itch Reduction | 47.1% | 23% | 47.2% | 19.9% |
Meaningful Pain Reduction | 49.1% | 27.5% | 48.6% | 22.7% |
In the DELTA 3 study, people who were previously treated with Anzupgo in DELTA 1 and DELTA 2 maintained their IGA-CHE score when Anzupgo was used as needed. These people did not need to resume Anzupgo for an average of 113 days out of the 252 days (36 weeks). A higher number of people who previously used the vehicle (that has no medicine in it) in DELTA 1 and DELTA 2 achieved an IGE-CHE score of 0 or 1 at the end of the study.
Baseline (Day 1 of DELTA 1 or 2) | End of the DELTA 3 Study (Week 36)
| |||
Received Anzupgo in DELTA 1 or 2 | Received Vehicle in DELTA 1 or 2 | Received Anzupgo in DELTA 1 or 2 | Received Vehicle in DELTA 1 or 2 | |
IGA-CHE of 0 (Clear) or 1 (Almost Clear) | 24.6% | 9.1% | 30% | 29.5% |
HECSI-75 | 51.8% | 23.7% | 58.6% | 51.5% |
HECSI-90 | 31.8% | 12% | 36.6% | 35.7% |
How Long Does It Take to Work?
In clinical studies, on average, people started seeing benefits in their chronic hand eczema after a few weeks, with greater improvements seen after a few months. Itch was assessed as early as week 2, and some people had meaningful itch reduction after two weeks of using Anzupgo. Clear or almost clear skin and meaningful pain relief were assessed as early as week 4, and some people saw these benefits after a month of using Anzupgo. Talk to your health care provider if you do not see an improvement in your chronic hand eczema symptoms after using Anzupgo. Your health care provider may add another medicine or prescribe a different medicine. Do not use more Anzupgo than prescribed without talking to your health care provider.
What Are The Side Effects and How Can I Manage Them?
Anzupgo is usually well tolerated, but in clinical studies, a very small number of people have had the following side effects: pain, itching, tingling, or redness where the medicine is applied, skin infections caused by bacteria like cellulitis and nail infections, and low white blood cell levels.
If you have skin reactions in the area where you apply Anzupgo, call your health care provider if these symptoms do not go away or get worse. Call your health care provider if you get any swelling, redness, pain, or tenderness of your skin, including your nails, or if you have a fever or chills.
Having low white blood cell levels may make it harder for your body to fight infections and can allow you to get sick more easily. Keep all appointments with your health care provider, including bloodwork appointments, while using Anzupgo. Avoid being near people who are sick and avoid large crowds. Practice good hygiene by washing your hands regularly, disinfecting surfaces, and avoiding touching your face. Anzupgo can reactivate certain infections that have stayed in your body after you have recovered from them. Tell your health care provider if you have an infection, keep getting sick, or have had hepatitis B, hepatitis C, or shingles.
Is There Additional Information About Anzupgo That I Should Know?
Anzupgo can increase your risk of developing certain types of skin cancers. It is important to protect your skin while using Anzupgo. Steps to help do this include limiting your time in the sun, wearing protective clothing, and wearing sunscreen. Do not use sun lamps and tanning beds, check your skin regularly while using Anzupgo, and talk to your health care provider if you notice any changes to your skin.
Talk to your health care provider if you have recently had any vaccines or have any vaccines scheduled. There are certain vaccines that you should not receive right before, during, or right after using Anzupgo. Your health care provider can determine which vaccines you can receive and which ones you cannot receive while using the medicine.
Talk to your health care provider if you are over 50 years old and have any risk factors for heart disease. In some clinical studies, when a JAK inhibitor that is taken by mouth was used to treat rheumatoid arthritis in this group of people, it increased their risk of death and some serious side effects. It is not known if Anzupgo has the same risks.
How Can I Learn More?
You can visit the drug maker’s website at www.anzupgo.com or call 877-494-4536. You can also speak with your health care provider to learn more.
