Patient Preferences for Treatment Attributes in Moderate to Severe Chronic Hand Eczema: A Discrete Choice Experiment

INTRODUCTION: The treatment landscape for Chronic Hand Eczema (CHE) is evolving; however, evidence on patients' preferences regarding CHE treatment attributes is sparse. This discrete choice experiment (DCE) assessed how treatment attributes influence preferences among patients with moderate to severe CHE in the USA. METHODS: Adults with moderate to severe CHE recruited from an online panel completed a web-based DCE survey (August-September 2025). Seven treatment attributes, identified via literature review, qualitative patient interviews, and clinical expert input, reflected efficacy (improvements in itch, skin appearance, and pain), safety (risks of infections, cancer, and major heart problems), and administration mode/frequency. Patient preferences were analyzed using conditional logistic regression. Attributes' relative importance and willingness to trade off were calculated. Sensitivity analysis excluding participants who failed ≥ 1 validity test was conducted. RESULTS: Of the 300 participants with CHE included (mean age: 44.9 years; 50% female; 84.7% employed), most reported multiple CHE subtypes (70.3%). The vast majority of participants reported life impairment due to CHE, including for activities of daily living (96.3%) and work productivity (92.9%). In the DCE, all treatment attributes had a significant impact on treatment preferences (p < 0.001). Attributes with the highest relative importance were related to efficacy: itch improvement (22%) and skin appearance improvement (21%); followed by those related to safety: avoiding risk of cancer (16%) and risk of infections (14%). Other important attributes for patients included pain improvement (13%) and administration mode/frequency (7%). Participants would forgo 28.1, 11.4, and 1.3 percentage points of itch improvement probability to avoid a 1-percentage-point risk of cancer, major heart problems, and infections, respectively. CONCLUSIONS: Improvement in efficacy outcomes (itch and skin appearance) and lower risks of certain adverse events (cancer, infections) were the most important treatment attributes for patients with CHE. This study provides insights that may help support shared decision-making to ultimately improve treatment satisfaction and adherence.