title: Safety and efficacy of local administration of contractubex to hypertrophic scars in comparison to corticosteroid treatment. Results of a multicenter, comparative epidemiological cohort study in Germany.
abstract: OBJECTIVE
  To investigate the safety and efficacy of Contractubex administration to hypertrophic scars in routine out-patient practice and to compare it to corticosteroid treatment.
  
  
  METHODS
  This was a multicenter, retrospective cohort study, based on 38 randomly selected practices representatively distributed in Germany, including dermatologists and general practitioners. Data from 859 patients fulfilling the inclusion criteria were assessed and analyzed. Of these, 771 patients were eligible for the per protocol treatment with Contractubex (n=555) and corticosteroid (n=216). The safety and efficacy of local administration of Contractubex to hypertrophic scars was compared to corticosteroid treatment.
  
  
  RESULTS
  At the end of defined treatment periods (minimum 28 days for local therapy with 1 intralesional corticosteroid application), normalization of the pre-treatment pathological parameters (erythema, pruritus, consistency) of hypertrophic scars was more frequent (42.5%) after Contractubex per protocol treatment as compared to corticosteroid per protocol treatment (22.2%). After adjusting imbalances of baseline characterisics between the treatment groups by the propensity score, the odds ratio was 2.274, demonstrating a significant superiority (p<0.001) of Contractubex treatment as compared to corticosteroid treatment. The time to normalization of erythema, pruritus and consistency was significantly (p=0.034) shorter with Contractubex treatment (median 344 days) than with corticosteroids (median 507 days). No unexpected or severe adverse events occurred in the Contractubex-treated patients. Apart from moderate pruritus (10% Contractubex vs. 1% corticosteroids), adverse events were significantly (p<0.001) more frequent in corticosteroid-treated patients (teleangiectasias 15% vs. 7% Contractubex; cutaneous atrophy of scars 10% vs. 2% Contractubex; cutaneous atrophy of scar surrounding skin tissue 11% vs. 1% Contractubex).
  
  
  CONCLUSIONS
  For the primary aim of this study (assessment of normalization of erythema, pruritus, and consistency of hypertrophic scars) and for time to normalization, local administration of Contractubex was significantly more effective than corticosteroid treatment. Concerning safety, Contractubex treatment was associated with significantly less adverse events (e.g. teleangiectasias, cutaneous atrophy of scars and surrounding skin tissue) than topical corticosteroid application.
authors.affiliation: Institut zur wissenschaflichen Evaluation naturheilkundlicher Verfahren an der Universitaet zu Koeln, 50331 Koeln, Germany. Hans.Beuth@uk-koeln.de
authors.forename: J
authors.initials: J
authors.lastname: Beuth
authors.forename: N
authors.initials: N
authors.lastname: Hunzelmann
authors.forename: R
authors.initials: R
authors.lastname: Van Leendert
authors.forename: R
authors.initials: R
authors.lastname: Basten
authors.forename: M
authors.initials: M
authors.lastname: Noehle
authors.forename: B
authors.initials: B
authors.lastname: Schneider
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000481:Allantoin / Q000627:therapeutic use*; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D015331:Cohort Studies; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005858:Germany / Q000453:epidemiology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010936:Plant Extracts / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D004338:Drug Combinations; D005938:Glucocorticoids; D010936:Plant Extracts; C053099:allantoin, heparin, onion extract drug combination; D000481:Allantoin; D006493:Heparin