A post hoc analysis of Dupuytren contracture treated with collagenase Clostridium histolyticum across disease stages

Abstract

This post hoc analysis from a multicenter study (NCT01674634) was designed to evaluate the efficacy of collagenase Clostridium histolyticum (CCH) treatment in patients with different stages of Dupuytren contracture. Previously untreated patients who received two concurrent injections of CCH in two affected joints in the same finger were assessed by disease severity (Tubiana stage). The mean (SD) improvement in total fixed flexion contraction (FFC) 31 days post-CCH treatment in 181 patients was: 71.1 (36.5)% for Tubiana I, 77.0 (21.0)% for Tubiana II, 72.0 (20.4)% for Tubiana III and 66.4 (22.2)% for Tubiana IV. Treatment of metacarpophalangeal and proximal interphalangeal joints in the same finger resulted in a mean (SD) improvement of 82.5 (24.8)% and 66.4 (27.9)%, respectively. In conclusion, CCH is an effective treatment alternative for all stages of Dupuytren contracture and it provides a less invasive treatment alternative to surgery with similar short-term efficacy in patients with more severe disease.

Keywords:

• Collagenase Clostridium histolyticum
• Dupuytren contracture
• fasciectomy
• fixed flexion contracture
• percutaneous needle fasciotomy

Acknowledgements

We thank Tine Weis (Gentofte Hospital, Hellerup, Denmark), Frederik Verstreken (Ortopedisch Centrum Antwerpen, Belgium) and Zsolt Szabo (BAZ University County Teaching Hospital, Miskolc, Hungary) for valuable discussions and participation in an advisory board meeting regarding treatment of Dupuytren disease. We also thank Hans Olivecrona (Sobi, Sweden) for continuous intellectual contribution and support during this project and Kristina Lindsten (Sobi, Sweden) for medical writing support in accordance with good publication practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Disclosures statement

GM Pess: Advisory Board for Sobi, Speaker Bureau for Endo Pharmaceuticals and royalties from Biomet, Inc.

L Dahlin: investigator in the trial of the post hoc analysis presented in this manuscript and in a trial sponsored by Polyganics, Netherlands.

M Sundbom, K Wilson and D Lindqvist: employees of Sobi and holders of equity interest in Sobi.

Additional information

Funding

This post hoc analysis was fully funded by Sobi that is responsible for the commercialization of collagenase clostridium histolyticum (Xiapex^®) in Europe.