Abrocitinib Shows Efficacy in Chronic Hand Eczema in Phase II Trial

Key Takeaways

• Abrocitinib significantly improved disease severity in chronic hand eczema (CHE), with reductions in mTLSS exceeding placebo at Week 16.
• Clinical responses were observed as early as Week 2 and were consistent across both atopic and non-atopic CHE populations.
• The safety profile was consistent with prior abrocitinib studies, with mostly mild-to-moderate adverse events.

Abrocitinib, an oral Janus kinase 1 (JAK1) inhibitor approved for atopic dermatitis, demonstrated significant efficacy in patients with chronic hand eczema (CHE) of diverse etiologies in a Phase II randomized trial presented at the American Academy of Dermatology (AAD) 2026 Annual Meeting.

Robert Bissonnette, MD, presented data from the double-blind, placebo-controlled study evaluating abrocitinib 200 mg and 100 mg once daily in 82 adults with refractory moderate-to-severe CHE. The trial included both atopic and non-atopic disease, a population in which treatment data have been limited.

“Up until we conducted that study, the efficacy was not well known…in this patient population,” Dr. Bissonnette said. 

At Week 16, the primary endpoint, percent change from baseline in modified Total Lesion Symptom Score (mTLSS), showed reductions of 81.4% (200 mg) and 78.1% (100 mg) compared with 46.5% for placebo (P < .001 for both doses). Improvements were observed early, with significant separation from placebo at Week 2 for the 200 mg dose.

Efficacy was consistent across subgroups, including patients with non-atopic CHE.

“We observed that efficacy in non-atopic CHE,” Dr. Bissonnette noted, with reductions of 79.2% and 71.3% for the 200 mg and 100 mg doses, respectively, versus 36.9% for placebo. 

Secondary endpoints also favored abrocitinib. Treatment success, defined as a ≥2-grade improvement to clear or almost clear, was achieved in 55.6% of patients receiving 200 mg and 44.4% receiving 100 mg, compared with 18.5% for placebo. Improvements in pain and pruritus were substantial, with reductions of up to 90% and 77%, respectively.

Dr. Bissonnette highlighted the rapid onset of action as clinically relevant.

Safety findings were consistent with the known profile of abrocitinib. Most adverse events were mild or moderate, with nasopharyngitis among the most common. One serious adverse event (breast cancer) was reported in the 200 mg group, though overall safety was considered in line with prior experience.

“Abrocitinib induced significant improvements in patients with CHE, (with) more than half of patients … clear or almost clear at week 16,” Dr. Bissonnette concluded.