Delayed manipulation after collagenase clostridium histolyticum injection for Dupuytren contracture

Hand : Official Journal of the American Association for Hand Surgery
F Thomas D KaplanRaymond Pahk

Abstract

Collagenase clostridium histolyticum (CCH) injection for Dupuytren contracture was approved in the USA in 2010. Current FDA guidelines stipulate that finger manipulation occurs the day following injection. To investigate the safety and efficacy of delaying manipulation to 2 or 4 days following CCH injection, we conducted a prospective, randomized trial at two sites. Patients with Dupuytren contracture involving the metacarpophalangeal (MCP) joint ≥20° caused by a palpable cord participated. All patients received one dose of CCH (0.58 mg/0.25 ml) and were followed for 90 days. The primary end point was the percent of patients maintaining clinical success (reduction of contracture to 0°-5°) at 90 days post-injection. Adverse events and change in Michigan Hand Questionnaire (MHQ) score were recorded as secondary end points. Thirty-seven patients enrolled; 13 were manipulated on day 1, 11 on day 2, and 13 on day 4. At 30 days after injection, the percentage of patients obtaining reduction of contracture to <0°-5° extension was 92, 82, and 85 % in groups 1, 2, and 3, respectively, with no significant difference. At 90 days follow-up, the percentage of patients maintaining 0°-5° extension was 91, 82, and 83 % in groups 1, 2, and 3, r...Continue Reading

References

Aug 26, 1998·The Journal of Hand Surgery·K C ChungR A Hayward
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Dec 3, 2011·The Journal of the American Academy of Orthopaedic Surgeons·Eric M Black, Philip E Blazar

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Citations

May 7, 2016·British Medical Bulletin·Francesco SmeragliaNicola Maffulli
Dec 28, 2016·Plastic and Reconstructive Surgery·Keith A DenklerScott L Hansen
Sep 1, 2018·The Bone & Joint Journal·E SoreideS Kakar
Dec 11, 2019·The Journal of Hand Surgery, European Volume·Bethany ReynoldsDavid J Hunter-Smith
Feb 10, 2017·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·Rafael Sanjuan-CerveróDiego Gomez-Herrero
Feb 6, 2020·The Journal of Hand Surgery, European Volume·Marta KarpinskiAchilleas Thoma

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