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Collagenase Injections Can Improve Range of Motion

Last Updated: September 02, 2009.

Injection of collagenase clostridium histolyticum into the affected hand joints of patients with Dupuytren's disease can reduce joint contracture, improve range of motion, and provide an office-based alternative to risky hand surgery, according to a study in the Sept. 3 issue of the New England Journal of Medicine.

WEDNESDAY, Sept. 2 (HealthDay News) -- Injection of collagenase clostridium histolyticum into the affected hand joints of patients with Dupuytren's disease can reduce joint contracture, improve range of motion, and provide an office-based alternative to risky hand surgery, according to a study in the Sept. 3 issue of the New England Journal of Medicine.

Lawrence C. Hurst, M.D., of the State University of New York in Stony Brook, and colleagues randomized 308 patients with Dupuytren's disease and joint contractures of 20 degrees or more to receive injections of collagenase clostridium histolyticum (0.58 mg per dose) or placebo in the contracted collagen cords at 30-day intervals. The study evaluated the end point of reduced contracture to zero to five degrees of full extension 30 days after the final injection, range of motion improvement, and adverse events.

In the group receiving collagenase injections, the researchers found that 64 percent achieved the reduced contracture end point compared to 6.8 percent for placebo. Range of motion improvement also was much greater with the collagenase injections than with placebo (43.9 to 80.7 degrees for collagenase versus 45.3 to 49.5 degrees for placebo). There were three serious adverse events, including two tendon ruptures and one regional pain syndrome. Most side effects were mild, such as injection site swelling, bruising, pruritus, transient lymph node swelling, and pain.

"Our data on 30-day outcomes indicate that this office-based procedure effectively reduced contractures and improved range of motion, thus providing an alternative to surgery," the authors conclude.

Several study authors reported receiving consulting fees or research grants from pharmaceutical companies.

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