Antithrombotic use with Collagenase Clostridium Histolyticum Injection to Treat Dupuytren Disease

This study assesses the joint-specific sustained effect of collagenase clostridium histolyticum treatment of Dupuytren disease over a 5-year follow-up period. The study includes 107 consecutive treatments in patients with extension deficits greater than 20° affecting the metacarpophalangeal or proximal interphalangeal joints. Success was defined as no follow-up treatment due to relapse or maintained extension deficit less than 20°. The 5-year estimate of no follow-up treatment was 79% (95% CI: 64–88) for metacarpophalangeal and 49% (95% CI: 26–69) for proximal interphalangeal joints, which was a significant difference (log-rank test, p = 0.0044). For those who did not undergo re-treatment, a non-significant relapse was found for metacarpophalangeal joints and a 65% (34°, 95% CI: 24–46) relapse for proximal interphalangeal joints. We conclude that treating metacarpophalangeal joints with collagenase clostridium histolyticum is effective with acceptable recurrence rates. However, when treating proximal interphalangeal joints with collagenase clostridium histolyticum, patients should be informed of the high risk of recurrence and the greater chance of need for further treatment. Level of evidence: II

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A Randomized Phase 2A, Double-blind, Placebo-controlled, Dose-ranging Study to Evaluate the Safety and Effectiveness of Collagenase Clostridium Histolyticum in the Treatment of Dupuytren Disease Nodules

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2016.07.058 ◽

2016 ◽

Vol 41 (9) ◽

pp. S31 ◽

Cited By ~ 1

Author(s):

Bronier Costas ◽

Stephen Coleman ◽

Gregory Kaufman ◽

Robert James ◽

Brian Cohen ◽

...

Keyword(s):

Collagenase Clostridium Histolyticum ◽

Double Blind ◽

Double Blind Placebo ◽

Clostridium Histolyticum ◽

Dose Ranging ◽

Dupuytren Disease

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Treatment of Single Cords in Dupuytren Disease with Collagenase Clostridium Histolyticum: Study of a Cohort with Follow-up at 1 Year

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0038-1654723 ◽

2018 ◽

Vol 46 (01) ◽

pp. 034-039

Author(s):

Ignasi Manent Bistué ◽

Sonia Suau Mateu ◽

Ana Maria López Louzao ◽

Pier Claudio Caputo ◽

Víctor Rodriguez Roiz ◽

...

Keyword(s):

Cohort Study ◽

Metacarpophalangeal Joint ◽

First Year ◽

Collagenase Clostridium Histolyticum ◽

Paired Data ◽

Clostridium Histolyticum ◽

Injectable Treatment ◽

Locoregional Anesthesia ◽

Dupuytren Disease

Objective The purpose of the present work was to assess the effectiveness of collagenase Clostridium histolyticum in patients with Dupuytren disease with single cords and assess the recurrence rate in the first year after the treatment. Material and Methods In this classic cohort study, a total of 53 patients (50 of them male) with a mean age of 68 years were studied who had been diagnosed with Dupuytren disease located in the metacarpophalangeal joint, in single cords, with more than 40° of extension loss. They were given an injection of collagenase C. histolyticum and later manipulation under locoregional anesthesia. The loss of extension was evaluated after a week and at the 1st, 3rd, 6th and 12th months. The effectiveness was analyzed with basis on the results of the Student t-test for paired data, as well as those of the effect size (ES) test. Results An important and statistically significant correlation was found for the loss of cord extension in the metacarpophalangeal joint (t = 32.113; p < 0.01; ES = 4.11; standardized response mean [SRM] = 4.15). Conclusion Collagenase is an injectable treatment, which is not very aggressive compared with surgery and is effective for the loss of extension in the metacarpophalangeal region secondary to single cord in Dupuytren disease during the first year.

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Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0037-1608749 ◽

2017 ◽

Vol 45 (02) ◽

pp. 070-088 ◽

Cited By ~ 1

Author(s):

Rafael Sanjuan-Cerveró ◽

Pedro Vazquez-Ferreiro ◽

Diego Gomez-Herrero ◽

Francisco Carrera-Hueso

Keyword(s):

Systematic Review ◽

Collagenase Clostridium Histolyticum ◽

Clostridium Histolyticum ◽

End Point ◽

Number Of Patients ◽

Bibliographic Search ◽

The Mean ◽

One Year ◽

Dupuytren Disease

Introduction Collagenase Clostridium Histolyticum (CCH) has become a therapeutic alternative for Dupuytren disease. However, its efficacy in the medium to long term is unknown. The objective of our study is to carry out a systematic review of the studies conducted on the subject. Material and Methods Systematic bibliographic search. Analysis depending on the time of progression, looking into 2 groups with the follow-up cut-off point of 1 year. Analysis of the number of patients who reached the primary endpoint, of the mean correction in degrees, and of the proportional correction of each joint. Results The 50 selected clinical trials encompass a total of 4,622 patients (an average of 92.70). A total of 7,546 joints were treated with the mean being 148.15 joints per trial (3,925 metacarpophalangeal [MCP] and 2,350 proximal interphalangeal [PIP]). In less than one year of progression, the primary end point was reached in 48.9% of the joints (69.77% of the MCPs and 30.14% of the PIPs), the mean correction in degrees was 45.5 (standard deviation [SD]: 19.18) degrees; 40.8 degrees in the MCP (SD: 10.12) and 35.6 in the PIP (SD: 13.23), and the proportional correction of the joints was 72.9% (SD: 14.43) (83.9% for MCPs [SD: 12.58] and 64.2 for the PIPs [SD: 16.35]). In the follow-ups over 1 year, the primary end point was reached at a rate of 57.5% (68.9% of the MCPs and 43.3% of the PIPs), the mean correction in degrees was 37.6 degrees (SD: 10.93) (37.3 degrees in the MCPs [SD: 9.98] and 23.7 in the PIPs [SD: 16.33]) and the proportional correction of the joints was 87.3% (SD: 10.96) (90.3% for MCP [SD: 6.94] and 75% for PIP [SD: 13.54]). Conclusions The results indicate a satisfactory response to CCH treatment maintained in the short and medium term. The recurrence rate is uncertain given the available data.

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