title: Analysis of efficacy and safety of treatment with collagenase Clostridium histolyticum among subgroups of patients with Dupuytren contracture.
abstract: Collagenase Clostridium histolyticum (CCH) injection is a nonoperative treatment of hand contractures from Dupuytren disease. This study assessed the efficacy and safety of CCH in several subgroups of patients with increased surgical risk.Data were pooled from 3 randomized, placebo-controlled, double-blind trials. This analysis included 271 patients with metacarpophalangeal (n = 167) or proximal interphalangeal (n = 104) joint contractures greater than or equal to 20 degrees treated with CCH (0.58 mg collagenase per injection). Subgroups included age, sex, and diabetes status. End points included rate of clinical success (reduction in contracture to 0-5 degrees of normal) and percentage of adverse events.There was no significant difference in clinical success by age, diabetes status, or sex with 63% reaching the end point. There was no difference in adverse events among the subgroups, with peripheral edema, contusion, and injection-site hemorrhage being most common.High-risk subgroups do not demonstrate differences in efficacy or safety with CCH treatment of Dupuytren-related contractures.
authors.affiliation: From the *Orthopaedic Surgery Specialists, Burbank, CA; †Auxilium Pharmaceuticals, Inc, Malvern, PA; ‡Plastic and Reconstructive Surgery, Southern Illinois Hand Center, Effingham, IL; and §Division of Plastic Surgery, Stanford University, Palo Alto, CA.
authors.forename: Raymond B
authors.initials: RB
authors.lastname: Raven
authors.forename: Harvey
authors.initials: H
authors.lastname: Kushner
authors.forename: Dat
authors.initials: D
authors.lastname: Nguyen
authors.forename: Nash
authors.initials: N
authors.lastname: Naam
authors.forename: Catherine
authors.initials: C
authors.lastname: Curtin
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D004387:Dupuytren Contracture / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D003012:Microbial Collagenase / Q000627:therapeutic use*; D008875:Middle Aged; D010361:Patients / Q000145:classification
chemical_list: D003012:Microbial Collagenase