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Alitretinoin Compliance in Patients with Chronic Hand Eczema

Annals of Dermatology 2021년 33권 1호 p.46 ~ 51
설정은, 김종욱, 홍성민, 조경제, 진우정, 박소희, 박인호, 정소영, 김효진,
소속 상세정보
설정은 ( Seol Jung-Eun ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
김종욱 ( Kim Jong-Uk ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
홍성민 ( Hong Seong-Min ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
조경제 ( Cho Gyeong-Je ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
진우정 ( Jin Woo-Jung ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
박소희 ( Park So-Hee ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology
박인호 ( Park In-Ho ) - Inje University College of Medicine Haeundae Paik Hospital Department of Dermatology
정소영 ( Jung So-Young ) - Inje University College of Medicine Haeundae Paik Hospital Department of Dermatology
김효진 ( Kim Hyo-Jin ) - Inje University College of Medicine Busan Paik Hospital Department of Dermatology

Abstract


Background: Oral alitretinoin is effective in the treatment of chronic hand eczema (CHE), and ≥12 weeks of alitretinoin treatment has been shown to be effective in Korean patients. However, in the real world, a considerable number of patients discontinue alitretinoin, which leads to treatment failure.

Objective: To evaluate the compliance rate of alitretinoin treatment and explore common reasons for poor compliance in patients with CHE in the real world.

Methods: We retrospectively reviewed the electronic medical records of CHE patients treated with alitretinoin. We defined ‘poor-compliance’ as subjects who were treated with alitretinoin for <12 weeks and ‘good-compliance’ as subjects who were treated with alitretinoin for ≥12 weeks. We reviewed the demographics, dose, and duration of alitretinoin usage, efficacy, and reasons for poor compliance.

Results: A total of 137 subjects were enrolled, and 77 (56.2%) did not complete the 12-week treatment with alitretinoin. Among them, the non-improvement rate was significantly higher in the poor-compliance group than in the good-compliance group (p<0.01). The main reasons for the alitretinoin cessation in the poor-compliance group were insufficient response (40.8%), followed by high cost (34.7%), and adverse events (24.5%).

Conclusion: Alitretinoin appears the preferred long-term treatment option for CHE. Although there are complaints about late efficacy, cost, and side effects, following proper explanation, these should not justify discontinuation. Physicians need to recognize the reasons for poor compliance with alitretinoin for each patient and suggest continuing alitretinoin for the successful treatment of CHE.

키워드

Alitretinoin; Compliance; Eczema; Hand

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