118.
Xiapex® (collagenase clostridium histolyticum) – treatment of
patients with Dupuytren’s contracture
Søren Larsen, Jens Christian Werlinrud, Tune Ipsen, Jens Lauritsen
Department of Orthopaedic Surgery Odense University Hospital; Department
of Orthopaedic Surgery, Odense University Hospital; Department of
Orthopaedic Surgery, Odense University Hospital; Department of Orthopaedic
Surgery, Odense University Hospital
Background:
Dupuytren’s contracture (DC) is a disorder that affect the
palmar fascia were a pretendinous cord with time causes the finger to flex
resulting in impaired hand function.
Purpose / Aim of Study:
The aim of this study was to evaluate the efficacy
and safety of Xiapex® in the treatment of DC. The study was initiated
following a Minimal Health Technology Assessment.
Materials and Methods:
The study was a prospective study on consecutive
series of patients with DC and flexion deformities of the metacarpophalangeal
and/or proximal interphalangeal joint of >200 . Primary end point was
reduction in contracture and improving hand function. All patients gave
informed consent.
Findings / Results:
74
patients were enrolled, 62 men and 12 women, mean
age 64 years [22-85]. 91% of the treated fingers are the 4. and 5. finger. At
manipulation cord disruption succeed in 97% of the patients at the first
attempt. Despite 31 % had skindisruption no infections were seen. Mean
DASH pre-injection was 17 [0- 52] and at 3 months follow-up 10 [0-61].
There was a mean reduction in contracture of 47° [-10-80°] At 3 months
patient satisfaction was high, 1 joint had recurrence of contracture.
Conclusions:
Our preliminary results are promising and we find Xiapex® a
good treatment option for DC-patients with a palpable cord. The treatment is
effective, well tolerated and with acceptable recurrence at 3 months.
