Therapie des Morbus Dupuytren mit Kollagenase Clostridium histolyticum

Abstract

All in all, 120 patients were treated (107 male, 13 female) (mean age 62 years, range 30-84 years). In 49% the little finger, in 44% the ring finger, in 4% the middle finger, and in 3% the index finger were treated. Full release was accomplished in 71%, partial release in 26%, and no change in 3% of the patients. The median contracture before the treatment was 37° for the metacarpophalangeal (MP) joint (range 25-100°) and 51° for the proximal interphalangeal (PIP) joint (range 30-97°). After 12 months, the mean contracture for the MP joint was 9° (range 0-25°) and 21° (range 10-36°) or the PIP joint. Adverse events occurred in 96% of patients within 3 months after treatment. No tendon ruptures, anaphylactic reactions, nerve, or ligament injuries were observed.

Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review

“…The fact that a greater number of patients have reached the primary end point in studies lasting more than 1 year is due, in part, to the fact that many of these studies have been funded by or related to the company that markets the drug, which is why the patient selection criteria, the surgeon's experience or the protocol for patient maintenance, minimizing the losses of individuals with a positive result, may be regarded as biased. 9,34,35,37,48,54,60 With regard to joint treatment, the demonstrated results concur with many of the series published. The outcome for the MCP joint is better than the outcome for the PIP, and the recurrences of the latter are also much more frequent.…”

“…56 The bibliography is variable in this regard. Twenty-seven articles refer to the systematic use of this device, 6,14,15,17,20,22,25,26,30,33,35,36,[38][39][40][41]44,[46][47][48][49]51,54,[57][58][59][60] and a multicenter study reports that only one of the centers used it without performing a statistical analysis of what this measurement could indicate. 61…”

Clinical features and management of superficial fibromatoses

“…Disease progression could be stopped in 81 % of cases and even reversed in 40 % of the patients, with follow‐up for > 4 years . Enzymatic fasciotomy using clostridial collagenase injection is used by some centers as an alternative to surgery . Recurrence of DC is common, depending on the method of treatment and age at onset – the earlier the condition develops in life the more likely it is to recur .…”

Klinische Merkmale und Management oberflächlicher Fibromatosen

“…. In einigen Zentren kommt als Alternative zur chirurgischen Intervention eine enzymatische Fasziotomie durch die Injektion von clostridialer Kollagenase zum Einsatz . Die Rezidivrate bei der DK ist hoch.…”