Delgocitinib for Chronic Hand Eczema: The DELTA Trials and the Adult Label
DOCTOR'S NOTES · ECZEMA EVIDENCE
Chronic hand eczema can make washing, cooking, working and handling ordinary objects painful. It can have several overlapping causes, so treatment starts with assessment of the actual hand condition and exposures. Delgocitinib is a topical prescription JAK inhibitor with an adult chronic-hand-eczema indication; it is not a general body moisturizer.
Who took part in DELTA?
The DELTA 1 and 2 randomized trials, published in The Lancet in 2024, enrolled adults with moderate-to-severe chronic hand eczema. DELTA 1 enrolled 487 people and DELTA 2 enrolled 473. Participants received delgocitinib cream or its inactive vehicle for 16 weeks. At the primary assessment, clear or almost clear hands were reported in about 20% versus 10% in DELTA 1 and 29% versus 7% in DELTA 2.
The overall frequency of reported adverse events was similar between groups during those trials. That does not establish identical risk for every person or rule out uncommon harms. The studies were specific to adult chronic hand eczema and do not justify use on an infant's rash or a different body site.
What the U.S. label covers
The ANZUPGO label describes treatment of moderate-to-severe chronic hand eczema in adults who have had inadequate response to topical corticosteroids or for whom they are inadvisable. It includes warnings about infection, non-melanoma skin cancers, immunization and potential JAK-related risks. It limits application to affected skin on the hands and wrists. Follow the exact prescribed amounts and directions.
| Before treatment | Question to bring |
|---|---|
| Diagnosis and contact exposures | Could irritation or a contact allergy be sustaining the hand eczema? |
| Other medicines and medical history | Do these change eligibility or monitoring? |
| Daily tasks | How should washing, glove use and treatment fit together? |
| Safety review | Which new symptoms require a call, and when is reassessment? |
Keep exposure control in the plan
A prescription does not eliminate the need to discuss wet work, protective equipment and individual allergies. Ask occupational health for help when work tasks are involved. Do not reduce infection-control measures or replace protective gloves with a cream.
For related diagnostic questions, see gloves, irritation and rubber allergy. If a topical product seems to worsen the rash, read questions about contact allergy to eczema medicines.
A hand-specific result needs a hand-specific interpretation
The DELTA outcome used a clinician assessment of chronic hand eczema. It should not be compared casually with a whole-body eczema score or a general hand-dryness claim. The populations and scales are different. Improvement in average symptoms can also occur without reaching the trial's clear-or-almost-clear endpoint, so ask about both disease scores and daily function.
For someone who works with water, cleaning products, food or protective equipment, the exposure history remains important even when a prescription helps. Bring a task list and the timing of symptoms rather than guessing that all glove-related problems have the same cause.
Agree on a workable hand-care plan
Ask the prescriber how application fits washing and work requirements, which other topical products should be reviewed and when the response will be assessed. Clarify the label's area and amount restrictions with the pharmacist. Do not use a hand-and-wrist prescription on a facial or infant rash by analogy. New infection symptoms or a changing skin lesion deserve contact with the treatment team rather than an independent increase in application.
Follow the related evidence
A hand prescription may prompt questions about topical potency and formulation. If a moisturizer appears to worsen the rash, the lanolin patch-test evidence shows how exposure and test relevance are interpreted.
Prepared by the Dr. Arsy editorial team. Sources checked November 8, 2026. Educational information supports a discussion with a qualified clinician; it does not diagnose or prescribe for an individual. The AI-created product image is an editorial illustration, not a patient photograph or a clinical result.