Isolated and Spontaneous Correction of Proximal Interphalangeal Joint Contractures in Dupuytren’s Disease: An Exploratory Analysis of the Efficacy and Safety of Collagenase Clostridium histolyticumReport as inadecuate




Isolated and Spontaneous Correction of Proximal Interphalangeal Joint Contractures in Dupuytren’s Disease: An Exploratory Analysis of the Efficacy and Safety of Collagenase Clostridium histolyticum - Download this document for free, or read online. Document in PDF available to download.

Clinical Drug Investigation

, Volume 33, Issue 12, pp 905–912

First Online: 05 October 2013

Abstract

Background and ObjectiveDupuytren’s contractures affecting proximal interphalangeal PIP joints are challenging to treat. We explored the effects of collagenase Clostridium histolyticum CCH on PIP joint contractures after injection of an affected metacarpophalangeal MP joint in the same finger and after injection of an isolated PIP joint contracture.

MethodsTwo patient subsets were evaluated: those with MP-PIP joints contractures in the same finger, but only the MP joint contractures were treated Group A; and those with isolated PIP joint contractures that were treated Group B. Endpoints included correction and improvement in contracture. Fixed-flexion contracture FFC and range of motion ROM were also assessed; adverse events AEs were monitored.

ResultsIn Group A, 28 and 43 % of PIP contractures spontaneously corrected after the first and last injection of CCH, respectively, for MP contractures; 40 and 63 %, respectively, improved. In Group B, 31 and 39 % of PIP joint contractures corrected after the first and last injection of CCH, respectively, 56 and 66 %, respectively, improved. In Groups A and B, FFC improvements were largest after the last injection; ROM improvements were largest after the last injection in Group A and third injection in Group B. For 46 and 44 % of patients in Groups A and B, respectively, the first injection was the last injection. In Group B, the median minimum, maximum injections-joint was 1.0 1.0, 4.0. Nearly all patients 98 % experienced ≥1 AE; most were injection-site reactions.

ConclusionsThe efficacy of CCH for improving PIP joint contracture was similar whether treated in isolation or after treatment of an MP joint contracture.

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Author: Michael J. Hayton - Ardeshir Bayat - Douglass S. Chapman - Robert A. Gerber - Piotr P. Szczypa

Source: https://link.springer.com/







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