Tuesday, 21 August 2012

Late complications with Collagenase injections?

Today I got an e-mail telling me that there was a new paper out relating to Dupuytren's (thank you Google Alerts), so I went and had a look and it is another paper that is looking at collagenases such as Xiapex/Xiaflex. For those who don't know these are enzymes that break down the main complex that forms the cords in Dupuytren's and I have heard that it does have some positive influence on nodules as well. 

For background information see some of my previous posts which include: 


 Still in this paper they are looking at patients after a time that is greater than that used in the phase III (the final phase) clinical trials:

Late Complications of Clinical Clostridium Histolyticum Collagenase Use in Dupuytren's Disease - It is an open access article so anyone can go and have a look and if you don't understand anything then please ask me questions and I can probably agree that I didn't understand either - Warning there are some graphic pictures of procedures being performed on a hand so don't look if you can't stand that sort of thing. 

What do they find

2 of 12 patients had problems. 
Well the typical follow up period in the trials was 3 months and here they go up to a year in what is unfortunately a small sample group of only 12 patients and they find that: (Just because I like at least one picture per blog post): 

Although the majority of the patients are fine 2 do have side effects, in the pie chart this may look like a small amount but imagine this applied to 1200 people rather than 12 and suddenly that is 200 people with problems. 

These two patients had significant disability in the injected hand and also suffered from pain and in both case operative intervention was taken a year after the treatment with the collagenase. They found that there was deep tissue scarring that was presumably caused by the injection and that this could be the cause of finger stiffness and pain. They then waffle on about science stuff and come to the conclusion that long term problems is something that those administering this drug should consider both before and after giving the treatment. 

If you are interested in learning more about this then please e-mail me, post a comment or hop over to the forum and share your story at the same time.