Delgocitinib for Hand Eczema: Questions Before a Prescription

Who is Anzupgo approved for?

The FDA approved delgocitinib cream on July 23, 2025 for adults with moderate-to-severe chronic hand eczema after an inadequate response to topical corticosteroids, or when those medicines are inadvisable. This is a defined prescription indication, rather than a general treatment for dry hands.¹

About 90% of participants in the two approval trials were White. The FDA says responses across other racial groups could not be determined because numbers were limited.¹

How often did hands become clear or almost clear?

DELTA 1 and DELTA 2 randomized 960 adults; 959 received treatment. Participants applied 2% delgocitinib or cream vehicle twice daily for 16 weeks. Vehicle means the cream preparation without the active medicine.²

The primary endpoint required clear or almost clear skin plus at least a two-step improvement on the investigator’s scale:²

Trial	16-week result
DELTA 1	20% with delgocitinib; 10% with vehicle2
DELTA 2	29% with delgocitinib; 7% with vehicle2

These percentages describe that endpoint, not every improvement. Among participants with baseline itch scores of at least 4/10, about 47% receiving delgocitinib achieved a four-point itch reduction, compared with 23% and 20% in the vehicle groups. LEO Pharma funded the trials and participated in their design, analysis and reporting.²

Has it been compared with a medicine taken by mouth?

DELTA FORCE randomized 513 adults with severe disease to delgocitinib cream or oral alitretinoin in countries where that comparator was licensed. The primary analysis included 499 participants with eligible baseline data.³

At 12 weeks, adjusted average Hand Eczema Severity Index reductions were 67.6 versus 51.5 points, favoring the cream; the scale runs 0–360. This measures severity change, not the percentage cured.³

Assessors were masked, but patients knew their treatment. LEO Pharma funded and helped conduct the trial. It does not establish superiority over topical corticosteroids or every other treatment.³

Does the longer study prove lasting clearance?

DELTA 3 followed 801 completers of the earlier trials for another 36 weeks, using delgocitinib as needed according to eczema severity. It was open-label, with no continuing vehicle comparison. Its main endpoint concerned adverse events.⁴

That design adds information about repeated treatment over time. It cannot establish that an initial course permanently clears eczema or that every participant used active medicine continuously for 52 weeks.⁴

Where and how much does the US label allow?

The June 2026 prescribing information specifies a thin layer twice daily on affected hands and wrists, with limits of 30 g per two weeks or 60 g per month. Avoid the eyes, mouth and other mucous membranes. Other JAK inhibitors or potent immunosuppressants are not recommended in combination.⁵

What needs discussion before starting?

The label warns against use with active or serious infection, recommends periodic skin examinations, and calls for vaccination review, including shingles vaccination. Avoid live vaccines immediately before, during and immediately after treatment.⁵

It also discusses potential JAK-inhibitor risks. Serious cardiovascular, clotting and cancer findings from an oral JAK-inhibitor rheumatoid-arthritis trial do not establish the same risk for this cream; the label says that association is unknown. Pregnancy data are insufficient.⁵

Bring your prior prescription names, how long you used them, what changed and what you stopped because of side effects. Add one practical goal, such as fewer painful cracks while dressing or being able to finish a work shift.

“What to Say at the Appointment” in Skin, Head to Toe helps organize the product history, the effect on daily life and the questions you want answered. For washing and workplace exposures, see our hand-eczema care article.