title: Clusters in Short-term Disease Course in Participants With Primary Dupuytren Disease.
abstract: OBJECTIVE
  The course of Dupuytren disease (DD) is thought to be progressive; however, the course differs for each patient. The purpose of this study was to study the rate and pattern of progression of DD.
  
  
  METHODS
  We prospectively analyzed the course of DD at intervals of 3 to 6 months in 247 Dutch participants with primary DD by measuring the surface area of nodules and cords and the total passive extension deficit. The association between surface area and Tubiana stage was tested with generalized estimating equations. Latent class models were used to study different clusters in changes regarding the course of the disease.
  
  
  RESULTS
  The variance in disease course between participants was large. Regarding the change in surface area (in all fingers) and total passive extension deficit (in the ring and little finger), different clusters were observed. Progression of disease was seen but there were also signs of stability and even regression. Patients with a smaller surface area at baseline were more likely to exhibit regression.
  
  
  CONCLUSIONS
  This study showed that DD is not always progressive and that up to 75% of patients have a different short-term disease course, such as stability or even regression of disease. This should be taken into account when evaluating the effects of treatment for early-phase DD and in the design of future studies. Furthermore, this information may be useful when counseling patients.
  
  
  METHODS
  Prognostic II.
authors.affiliation: Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: r.lanting@umcg.nl.
authors.forename: Rosanne
authors.initials: R
authors.lastname: Lanting
authors.affiliation: Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Paul M N
authors.initials: PM
authors.lastname: Werker
mesh_terms: D000368:Aged; D018450:Disease Progression; D004387:Dupuytren Contracture / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D011379:Prognosis; D011446:Prospective Studies
keywords: Disease course; Dupuytren contracture; Dupuytren disease; disease progression; disease regression