Sunday, 8 April 2012

Verapamil for treatment of Ledderhose Disease and related disorders

Verapamil gel for the treatment of Plantar Fibromas / Plantar Fibromatosis / Ledderhose Disease:

After my interview with Petricd I said I would do a post on Verapamil gel and so here it is. This is a gel which you rub on to the lump. It is advertised as for use with Dupuytren's and Ledderhose and a good place to go for information (albeit a place that is trying to sell the stuff) is pdlabs (1a).

How and why does Verapamil gel help a plantar fibroma / ledderhose disease?

Right so this is the bit where a little bit of research is required. I figure that a good place to start is the pdlabs website and for the purposes of this post I went to the Ledderhose disease section (1b). Here they explain that the nodules that form in Ledderhose disease or indeed Dupuytren's contracture are mainly caused by an excess of collagen and that one of the requirements for collagen production is calcium and that verapamil works as it is a calcium channel blocker. The idea is that in cells you have a battle between the production of collagen and the breakdown of collagen and in the disease cells the battle is being won by collagen production so it builds up but by adding in verapamil you reduce the levels of collagen production and turn the course of the war in the favour of collagen breakdown which it then ideally wins by breaking down the lump or they reach a stalemate by at least stopping progression. 

Results?: 

This is where is gets a bit tricky. So to start with I have referred to the book Dupuytren's Disease and related hyperproliferative disorders (2). They say that this is still a work in progress but that the reports that have been generated so far by users on the Dupuytren's online forum suggest that it does not work very well. A very good thread to look at here is this one. Some of the comments that members have are quite harsh and it makes you wonder about the validity of the results PDlabs say they have below. Anyway here are some quotes from the thread I have linked to above: 

Randy H - "Contact the folks at PD labs and ask for any published studies on the product for your particular usage. I doubt they have anything. I tried it anyway........with no results." 

Bruce - " ...it is a complete waste of money and time. These guys should be shut down for deception."

JimH- "It does nothing. Ask your MD what information he has regarding its effectiveness and I'll bet he admits he has none."

Debrr - "Just to let you know I gave up on verapamil. Overall, didn't seem to do anything for me."

If you have a look round the forum most of the reviews by members that have Dupuytren's, Ledderhose or both are negative but still on to the other side of things.

So what do PDlabs say? Well they say that you need to be using this for 6-12 months and that those that are experience pain find that this is the first thing to disappear and that this usually happens within 90 days. They say that they are in the middle of clinical trials and that they are so far going very, see this page for details but to summarise they say that 100% of patients are experiencing a decrease in pain and most are having a decrease in size as well. 

Side Effects

As far as I am aware there are no side effects to using this on your feet, however it is also in use (though not for LD/DD treatment) in the form of a tablet which does have some side effects but I won't put them here as they might confuse things. 

Experience

I have had no experience with this but I have come across several posts on the Dupuytren's online forum but most of the people that have had this treatment have not got back to me. The one person that has though is the one that I mentioned earlier, Petricd, whom has had some success with verapamil on their Ledderhose but not their Dupuytren's. 

References

(1a) - http://pdlabs.net - Site accessed 07/04/2012 - a provider of Verapamil.
(1b) -http://pdlabs.net/plantar_fibromatosis/whatIsTvGel_plantar.html
(2) Dupuytren’s Disease and Related Hyperproliferative Disorders, Principles, Research, and Clinical Perspectives Eaton, C.; Seegenschmiedt, M.H.; Bayat, A.; Gabbiani, G.; Werker, P.; Wach, W. (Eds.) 2012.