A post hoc analysis of Dupuytren contracture treated with collagenase Clostridium histolyticum across disease stages

J Plast Surg Hand Surg. 2018 Oct;52(5):301-306. doi: 10.1080/2000656X.2018.1484753. Epub 2018 Jul 24.

Abstract

This post hoc analysis from a multicenter study (NCT01674634) was designed to evaluate the efficacy of collagenase Clostridium histolyticum (CCH) treatment in patients with different stages of Dupuytren contracture. Previously untreated patients who received two concurrent injections of CCH in two affected joints in the same finger were assessed by disease severity (Tubiana stage). The mean (SD) improvement in total fixed flexion contraction (FFC) 31 days post-CCH treatment in 181 patients was: 71.1 (36.5)% for Tubiana I, 77.0 (21.0)% for Tubiana II, 72.0 (20.4)% for Tubiana III and 66.4 (22.2)% for Tubiana IV. Treatment of metacarpophalangeal and proximal interphalangeal joints in the same finger resulted in a mean (SD) improvement of 82.5 (24.8)% and 66.4 (27.9)%, respectively. In conclusion, CCH is an effective treatment alternative for all stages of Dupuytren contracture and it provides a less invasive treatment alternative to surgery with similar short-term efficacy in patients with more severe disease.

Keywords: Collagenase; Dupuytren contracture; fasciectomy; fixed flexion contracture; percutaneous needle fasciotomy.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study

MeSH terms

  • Clostridium histolyticum*
  • Dupuytren Contracture / classification
  • Dupuytren Contracture / drug therapy*
  • Female
  • Finger Joint
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Male
  • Metacarpophalangeal Joint
  • Microbial Collagenase / therapeutic use*
  • Middle Aged
  • Severity of Illness Index*

Substances

  • Microbial Collagenase