Toctino (alitretinoine) is an A-vitamin derivative approved for systemic treatment of adult patients suffering from refractory severe chronic hand eczema. The treatment is administered as capsules of 10 or 30 mg once a day for 12 – 24 weeks.
Toctino has not been compared with active treatment.
After 24 weeks of treatment with 10 or 30 mg alitretinoine or placebo is a therapeutic response seen in 16,6 % in the placebo group against respectively 47,7 % in the 30 mg group (p<0,001) and 27,5 % in the 10 mg group (p=0,004).
The most frequent side effects are headache, blushing, dry lips, dry skin and increased cholesterol and triglyceride values and decreasing TSH-values. Alitretinoine is, as other retinoids, teratogenous.
The price for 12 – 24 weeks of treatment are whichever dose 14.334 – 28.688 Dkr. Toctino is not under the rules of general reimbursement.
On this basis, IRF states, that Toctino is an expensive treatment, which should be reserved for patients, where hand eczema can not be cured spontaneously, even after using a potent topical corticosteroid.
Toctino was marketed the 6th of October 2008.