Friday, November 13, 2009

New Treatment for Dupuytrens



The FDA's Arthritis Advisory Committee has approved a new treatment for treating advanced Dupuytren's disease. If approved, this would be the first nonsurgical therapy for the disorder.

Dupuytren's disease (named for Guillaume Dupuytren, 1778, of course) is a formation of scar tissue under the skin of the palm of the hand. This scar tissue pulls the flexor tendon of the fingers and causes the fingers to slowly be pulled into a grip. Over time, the contracture progresses and the skin is pulled in a fixed flexed position. Dupuytren's disease is inherited and it occurs mainly in males.

When the Dupuytren contracture was bad enough, the only treatment previously was surgical release of the scar tissue. (see image above...yikes) Even after surgery, the disease can recur. The new treatment is an injectable biologic treatment that breaks down collagen. The bacterium Clostridium histolyticum, is injected into the cord at 4 week intervals for three injections. In double blind studies, patients treated with collagenase clostridium had almost a complete reduction in contractures compared with those who received placebo.

Ain't science wonderful?

10 comments:

Anonymous said...

Thanks for this. My husband has this disease and was about to get his second surgery.

KM said...

Does this also work when a patient is told they have a trigger finger from arthritis? I have a relative who was told she have a trigger finger that can be corrected with surgery, but doesn't want the surgery.

Toni Brayer MD said...

Anon: I am glad to be of service. The only problem is, it is not yet approved by FDA so he will need to wait.

KM: Trigger finger is quite different. It is a tendonitis and it usually responds to a corticosteroid injection.

CountryMidwife said...

My dad's hands are SO contracted from this, I'll pass it along. Is it true that Duputrens can be traced back to one family lineage in Ireland?

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Stefano said...

I think that the better treatment will be a combination of needle-aponeurothomy (http://www.dupuytren.it - http://www.dupuytren-online.info/needle_aponeurotomy.html) for the relaxing of the cords and the drug injection to treat the nodules.
No invasive surgery will be necessary.

Anonymous said...

It has nothing to do with the flexor tendons. It is shrinking of the fascia of the palm.

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