Oral alitretinoin (9-cis-retinoic acid) therapy for chronic hand dermatitis in patients refractory to standard therapy: Results of a randomized, double-blind, placebo-controlled, multicenter trial

Thomas Ruzicka, Frederik Grønhøj Larsen, Dorota Galewicz, Attila Horváth, Peter Jan Coenraads, Kristian Thestrup-Pedersen, Jean Paul Ortonne, Christos C. Zouboulis, Martin Harsch, Thomas C. Brown, Maurice Zultak

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Abstract

Objective: To assess the efficacy and safety of oral alitretinoin (9-cis-retinoic acid), 10 mg/d, 20 mg/d, and 40 mg/d, compared with placebo control, in the treatment of chronic hand dermatitis. Design: Multicenter, randomized, double-blind, placebo-control, prospective trial. Setting: A total of 43 outpatient clinics in 10 European countries. Patients: Of 348 patients screened, 319 with moderate or severe refractory chronic hand dermatitis were randomized, in the ratio of 1:1:1:1, to 4 treatment groups and received allocated intervention. Of 75 patients who withdrew, 24 withdrew owing to adverse events. Interventions: Placebo or 10 mg, 20 mg, or 40 mg of oral alitretinoin (9-cis-retinoic acid) taken once daily for 12 weeks. Safety was assessed for all patients during a follow-up period of 4 weeks, and responders were observed for a follow-up period of 3 months. Main Outcome Measure: Physician's global assessment of overall chronic hand dermatitis severity. Results: Alitretinoin led to a significant and dose-dependent improvement in disease status, with responses in up to 53% of patients, and up to a 70% mean reduction in disease signs and symptoms. Treatment was generally well tolerated, with dose-dependent effects comprising headache, flushing, mucocutaneous events, hyperlipidemia, and decreased hemoglobin and decreased free thyroxin levels. Three months after discontinuation of treatment, the rate of relapse was 26%, independent of dose. Conclusion: Alitretinoin given at well-tolerated doses induced substantial clearing of chronic hand dermatitis in patients refractory to conventional therapy.

Original languageEnglish
Pages (from-to)1453-1459
Number of pages7
JournalArchives of dermatology
Volume140
Issue number12
DOIs
Publication statusPublished - Dec 1 2004

ASJC Scopus subject areas

  • Dermatology

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    Ruzicka, T., Larsen, F. G., Galewicz, D., Horváth, A., Coenraads, P. J., Thestrup-Pedersen, K., Ortonne, J. P., Zouboulis, C. C., Harsch, M., Brown, T. C., & Zultak, M. (2004). Oral alitretinoin (9-cis-retinoic acid) therapy for chronic hand dermatitis in patients refractory to standard therapy: Results of a randomized, double-blind, placebo-controlled, multicenter trial. Archives of dermatology, 140(12), 1453-1459. https://doi.org/10.1001/archderm.140.12.1453