Collagenase clostridium histolyticum for Dupuytren's contracture

Abstract

Importance of the field: Dupuytren's disease is a non-malignant, progressive disorder of the hands that can severely limit hand function and diminish overall quality of life. With global life expectancy increasing, the prevalence of this disease appears to be increasing amongst all ethnic groups. Treatment has traditionally remained surgical with few effective, nonsurgical options. However, with the introduction of collagenase clostridium histolyticum to treat Dupuytren's contractures, physicians and surgeons may be provided with a new, office-based, non-surgical option to treat this disease.

Areas covered in this review: The literature behind the use of collagenase to treat Dupuytren's disease; including its mechanism of action, safety, efficacy and clinical evidence behind its recent FDA approval.

What the reader will gain: The latest information available on collagenase through a comprehensive review of PubMed and the websites of licensing organizations for medicinal products.

Take home message: Phase III, clinical trials on collagenase for treatment of Dupuytren's contractures have recently been completed. Meeting primary and secondary objectives, collagenase has obtained FDA approval for clinical use. Collagenase now provides a non-operative option for Dupuytren's disease. Although short-term results show that collagenase is safe and efficacious, long-term effects of repeat injections and contracture recurrence rates have yet to be examined.

Keywords::

• collagenase injections
• Dupuytren's disease
• enzymatic fasciotomy
• hand contractures

Acknowledgements

We thank JP Tursi, (Auxilium Pharmaceuticals, Inc.) for the information and figures provided in preparing this manuscript.