scholarly journals Acute double flexor tendon ruptures following injection of collagenase clostridium histolyticum (Xiapex) for Dupuytren's contracture

2014 ◽  
Vol 2014 (apr12 1) ◽  
pp. bcr2013203338-bcr2013203338 ◽  
Author(s):  
B. Povlsen ◽  
S. Singh
Keyword(s):  
Flexor Tendon ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Tendon Ruptures

scholarly journals Magnetic resonance imaging of diffusion characteristics following collagenase clostridium histolyticum injection in Dupuytren’s contracture

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110472
Author(s):  
Hiroko Iwakawa ◽  
Shigeharu Uchiyama ◽  
Yasunari Fujinaga ◽  
Masanori Hayashi ◽  
Masatoshi Komatsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Resonance Imaging ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Signal Change

Purpose We aimed to evaluate the extent of collagenase clostridium histolyticum (CCH) diffusion in Dupuytren’s contracture (DC) for tissues outside of the contracture cord using Magnetic Resonance Imaging (MRI) immediately after CCH injection. Methods: 10 male patients aged 57–79 with DC of the metacarpophalangeal (MCP) joints were examined. Extension deficits were 10–60°(mean, 34.3) and 0–60°(mean, 26.6) in the MCP and proximal interphalangeal (PIP) joints, respectively. CCH injection was performed according to the standard method. MRI was performed within 15 min of CCH injection. Results: In all 10 cases, the extended area of high-intensity signal change outside of the cord was observed on short-T1 inversion recovery images (STIRs). Continuity from the insertion site was observed in the area of signal change involving the flexor tendon and neurovascular bundle. The signal change area spanned distally and proximally beyond the injection level. The signal change area expanded along the tendon sheath but no signal changes were observed inside the flexor tendon, suggesting the tendon sheath serves as a protective barrier from the CCH solution. After 1 week of injection, the mean decrease in contracture was 32.5°(94.7%) for the MCP joint and 19.8°(74.4%) for the PIP joint. In nine out of 10 cases, the extension deficit was within five degrees of full extension in the affected finger. There was no neurovascular injury or tendon rupture at 3 months of observation. Conclusions: MRI indicated the possible leakage of the drug outside of the cord during the early phase after administration, suggesting that CCH could persistently affect healthy tissues until CCH inactivates its enzyme process.

Efficacy and safety of collagenase Clostridium histolyticum injection for Dupuytren’s contracture in non-Caucasian Japanese patients (CORD-J Study): the first clinical trial in a non-Caucasian population

2016 ◽  
Vol 42 (1) ◽  
pp. 30-38 ◽  
Author(s):  
H. Hirata ◽  
K. Tanaka ◽  
A. Sakai ◽  
R. Kakinoki ◽  
H. Ikegami ◽  
...  
Keyword(s):  
Clinical Success ◽  
Japanese Patients ◽  
Phase Iii ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Open Label ◽  
Level Of Evidence ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Corrective Effect

To assess the efficacy, safety and pharmacokinetics of 0.58 mg collagenase Clostridium histolyticum injections for the treatment of Dupuytren’s contracture in Japanese patients, we conducted a phase III, multicentre, uncontrolled, open-label clinical study in patients with Dupuytren’s contracture. Of the 77 patients, 66 achieved clinical success in the primary treated joint (86%; 95% confidence interval: 76% to 93%), confirming the efficacy of collagenase Clostridium histolyticum injections. More improvement was seen in the metacarpophalangeal joints than in the proximal interphalangeal joints (94% versus 73%). The main adverse reaction was a local reaction in the injected hand. No tendon rupture or anaphylactic reactions were seen. The concentrations of collagenase Clostridium histolyticum were below the lower limit of quantification in plasma samples at all time points. As seen in global studies in Caucasian patients, a corrective effect on Dupuytren’s contracture and good tolerance were observed in most non-Caucasian (Asian) Japanese patients. Level of Evidence: Level 3

scholarly journals The efficacies and limitations of fasciectomy and collagenase clostridium histolyticum in Dupuytren’s contracture management: A meta-analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092174 ◽  
Author(s):  
Tokai B Cooper ◽  
Keshav Poonit ◽  
Chenglun Yao ◽  
Zeyuan Jin ◽  
Jingwei Zheng ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Treatment Algorithm ◽  
Cochrane Library ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Palmar Aponeurosis ◽  
The Mean

Background: We intend to assess the efficacies and limitations of collagenase clostridium histolyticum (CCH) and fasciectomy in treating Dupuytren’s contracture, and the associated complications and rate of recurrences aiming to present a treatment algorithm. Methods: A literature search within the PubMed, Web of Sciences, Cochrane Library, and EMBASE databases was performed using the combined key words ‘Dupuytren, palmar aponeurosis contracture, collagenase clostridium histolyticum and fasciectomy’, including all possible studies with a set of predefined inclusion and exclusion criteria. Results: Thirty studies were assessed for eligibility from 215 identified records. Seventeen publications satisfied the inclusion criteria including 2142 joints in 1784 patients. The mean follow-up time was 18.0 months (3–60). Conclusion: Acceptable contractures release was obtained in both techniques. Severe complications associated with fasciectomy outrank those of CCH, whereas the low rate of recurrence favors the fasciectomy technique.

Collagenase Clostridium Histolyticum versus Limited Fasciectomy for Dupuytren’s Contracture

2015 ◽  
Vol 136 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Chao Zhou ◽  
Steven E. R. Hovius ◽  
Harm P. Slijper ◽  
Reinier Feitz ◽  
Christianne A. Van Nieuwenhoven ◽  
...  
Keyword(s):  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Limited Fasciectomy
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