PMID- 24254968
OWN - NLM
STAT- MEDLINE
DCOM- 20170810
LR  - 20211021
IS  - 2035-5114 (Electronic)
IS  - 2035-5114 (Linking)
VI  - 98
IP  - 3
DP  - 2014 Dec
TI  - Efficacy and safety of collagenase Clostridium histolyticum injection for 
      Dupuytren contracture: report of 40 cases.
PG  - 225-32
LID - 10.1007/s12306-013-0304-x [doi]
AB  - BACKGROUND: Dupuytren's disease (DD) is a fibroproliferative pathology that 
      affects the palmar aponeurosis causing the development of nodules and collagen 
      cords and the progressive flexion of the fingers. The standard procedure is 
      surgical fasciectomy, followed by high recurrence rates. Collagenase Clostridium 
      histolyticum (CCH) injection represents an innovative noninvasive approach to the 
      treatment of DD. This prospective study was designed to examine the efficacy and 
      safety of CCH injection performed in the outpatient, using local anesthesia. 
      MATERIALS AND METHODS: Forty patients [32 metacarpophalangeal (MP), 8 proximal 
      interphalangeal (PIP)] with Dupuytren's contracture of at least 20 degrees  for MP joint 
      and any degree for PIP joint were included. The mean age was 66. All joints were 
      treated with a single vial of collagenase injection and manual breaking of the 
      cord 24 h after. All adverse effects (AEs) were monitored. Patients were checked 
      7, 30, 90, and 180 days after the injection. Primary endpoint was a reduction in 
      digit contracture within 0 degrees -5 degrees  of normal extension. Secondary endpoints were the 
      improvement of range of motion, the evaluation of AEs incidence, and 
      cost-effectiveness of collagenase treatment. RESULTS: About 67.5 % of patients 
      obtained a clinical success. At 6 months, a further 7.5% attained the same 
      result. The mean contracture of treated joints was 5.3 masculine for MP and 6.8 degrees  for PIP 
      joints. Twenty-three patients had one or more mild-to-moderate side effects. 
      CONCLUSIONS: The use of collagenase appears to be an effective and safe method 
      for the treatment of Dupuytren's contracture. Therapeutic success was achieved in 
      a significant percentage of patients. The incidence of side effects was higher, 
      but they were local reactions of short duration. The use of a single collagenase 
      vial in patients treated in day surgery appears more cost-effective than surgery.
FAU - Alberton, F
AU  - Alberton F
AD  - Department of Hand Surgery, University Hospital of Verona, Policlinico GB Rossi, 
      Piazzale LA Scuro 10, Verona, Italy.
FAU - Corain, M
AU  - Corain M
FAU - Garofano, A
AU  - Garofano A
FAU - Pangallo, L
AU  - Pangallo L
FAU - Valore, A
AU  - Valore A
FAU - Zanella, V
AU  - Zanella V
FAU - Adani, R
AU  - Adani R
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20131120
PL  - Italy
TA  - Musculoskelet Surg
JT  - Musculoskeletal surgery
JID - 101498346
RN  - 0 (Enzymes)
RN  - EC 3.4.24.3 (Microbial Collagenase)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cost-Benefit Analysis
MH  - Dupuytren Contracture/*drug therapy/therapy
MH  - Enzymes/administration & dosage/economics
MH  - Fasciotomy
MH  - Female
MH  - Humans
MH  - Injections, Intralesional/economics
MH  - Male
MH  - Manipulation, Orthopedic
MH  - Microbial Collagenase/*administration & dosage/economics
MH  - Middle Aged
MH  - Prospective Studies
MH  - Range of Motion, Articular
MH  - Treatment Outcome
EDAT- 2013/11/21 06:00
MHDA- 2017/08/11 06:00
CRDT- 2013/11/21 06:00
PHST- 2013/08/06 00:00 [received]
PHST- 2013/10/30 00:00 [accepted]
PHST- 2013/11/21 06:00 [entrez]
PHST- 2013/11/21 06:00 [pubmed]
PHST- 2017/08/11 06:00 [medline]
AID - 10.1007/s12306-013-0304-x [doi]
PST - ppublish
SO  - Musculoskelet Surg. 2014 Dec;98(3):225-32. doi: 10.1007/s12306-013-0304-x. Epub 
      2013 Nov 20.