Dupuytren’s disease: overview of a common connective tissue disease with a focus on emerging treatment options

Warwick, David; Thomas, Arthur L.; Bayat, Ardeshir

doi:10.2217/ijr.12.25

Cited by 11 publications

(11 citation statements)

References 99 publications

(108 reference statements)

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“…Secondary end points included percent change from baseline in surface area (as measured by ultrasound) of the treated nodule at Week 8, change from baseline in consistency and hardness of the treated nodule at Week 8, change in nodule pain from baseline to Week 8, investigator global assessment of improvement and patient satisfaction at Week 8, and composite responder analysis at Week 8. Patients who reported being satisfied with treatment (ie, responded very satisfied [ 1 ] or quite satisfied [ 2 ]) and reported improvement according to investigator assessment (ie, very much improved [ 1 ], much improved [ 2 ], or minimally improved [ 3 ]) were considered composite responders.…”

Section: Methodsmentioning

confidence: 99%

“…Dupuytren disease is a common fibroproliferative disease of the palmar fascia [ 1 ] that is reported to affect between 1% and 32% of individuals in Western countries [ 2 , 3 ]. It is characterized by the formation of thick collagen nodules that can progress to fibrous cords capable of producing digital flexion contractures and reducing hand function [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The CCH formulation Xiaflex® (Endo Pharmaceuticals Inc., Malvern, PA, USA) is a combination of two Clostridium histolyticum collagenases (AUX-I and AUX-II) that is currently approved in the United States, Europe, and Australia for the treatment of adult patients with Dupuytren contracture with a palpable cord [ 1 ]. These enzymes hydrolyze type I and type III collagen into smaller peptides, which may then be degraded by endogenous human collagenases [ 1 ]. In two phase 3 trials (Collagenase Option for the Reduction of Dupuytren [CORD I and CORD II]), injection of CCH into the cords of patients with Dupuytren contracture reduced joint contraction to 0–5° of full extension within 30 days of the last injection in a significantly greater percentage of joints versus placebo injection (CORD I: 64.0% with CCH vs 6.8% with placebo; CORD II: 44.4% vs 4.8%; P < 0.001 for both) [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of collagenase clostridium histolyticum for Dupuytren disease nodules: a randomized controlled trial

Costas

Coleman

Kaufman³

et al. 2017

BMC Musculoskelet Disord

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BackgroundTo determine the safety and efficacy of collagenase clostridium histolyticum (CCH) injection for the treatment of palmar Dupuytren disease nodules.MethodsIn this 8-week, double-blind trial, palpable palmar nodules on one hand of adults with Dupuytren disease were selected for treatment. Patients were randomly assigned using an interactive web response system to receive a dose of 0.25 mg, 0.40 mg, or 0.60 mg (1:1:1 ratio) and then allocated to active treatment (CCH) or placebo (4:1 ratio). All patients and investigators were blinded to treatment. One injection was made in the selected nodule on Day 1. Caliper measurements of nodule length and width were performed at screening and at Weeks 4 and 8. Investigator-reported nodular consistency and hardness were evaluated at baseline and Weeks 1, 4, and 8. Investigator-rated patient improvement (1 [very much improved] to 7 [very much worse]) and patient satisfaction were assessed at study end.ResultsIn the efficacy population (n = 74), percentage changes in area were significantly greater with CCH 0.40 mg (−80.1%, P = 0.0002) and CCH 0.60 mg (−78.2%, P = 0.0003), but not CCH 0.25 mg (−58.3%, P = 0.079), versus placebo (−42.2%) at post-treatment Week 8. Mean change in nodular consistency and hardness were significantly improved with CCH versus placebo at Weeks 4 and 8 (P ≤ 0.0139 for all). At Week 8, investigator global assessment of improvement was significantly greater with CCH 0.40 mg and 0.60 mg (P ≤ 0.0014) but not statistically significant with CCH 0.25 mg versus placebo (P = 0.13). Most patients were “very satisfied” or “quite satisfied” with CCH 0.40 mg and 0.60 mg. Contusion/bruising (50.0% to 59.1%) was the most common adverse event with CCH treatment.ConclusionIn patients with Dupuytren disease, a single CCH injection significantly improved palmar nodule size and hardness. The safety of CCH was similar to that observed previously in patients with Dupuytren contracture.Trial registration ClinicalTrials.gov identifier: NCT02193828. Date of trial registration: July 2, 2014 to December 5, 2014

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and safety of collagenase clostridium histolyticum for Dupuytren disease nodules: a randomized controlled trial

Costas

Coleman

Kaufman³

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The method of resonance near-field microwave tomography, which allows to study the spatial distribution of the dielectric permeability and conductivity of living tissues with a resolution significantly lower than the wavelength λ, has broad prospects among non-invasive diagnostic methods. Unlike passive microwave sensing, nearfield tomography requires a much smaller sensor (probe), and the resolution increases significantly [8][9][10][11][12][13][14].…”

mentioning

confidence: 99%