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What are the latest advances in Dupuytrens Contracture?
Latest advances in Dupuytrens Contracture: recent research, treatments in development and what they could mean, with sources.
Newer advances in Dupuytren’s disease
There is ongoing research into the genetics of Dupuytren’s disease, which has improved the understanding of the condition. A positive association of HLA-DRB1*15 with Dupuytren's disease in Caucasians has been described.23 An increase in expression of the TGF β-2 gene has been demonstrated in cords from Dupuytren’s tissue.24 Several biomarkers have also been identified in Dupuytren’s tissue which may have implications in future diagnostics and treatments.25
A further recent and significant advance in the treatment of Dupuytren’s disease has been the development of enzymatic fasciectomy with clostridial collagenase. Hurst et al performed a prospective, randomised, double-blind, placebo-controlled, multicentre trial of collagenase from Clostridium histolyticum injection in 308 patients with Dupuytren’s disease, particularly with contractures of 20º or more. Collagenase injections were found to significantly reduce contractures and improve the range of movement in affected joints.26 An eight-year follow-up of a small subgroup of these patients showed recurrence of the disease in four of the six metacarpophalangeal joint (MCPJ) contractures treated and in both of the two PIPJ contractures, although the severity of recurrence in the MCPJ was less when compared with the initial disease.27
http://www.boneandjoint.org.uk/content/focus/current-treatment-dupuytren%E2%80%99s-disease-and-newer-advances
There is ongoing research into the genetics of Dupuytren’s disease, which has improved the understanding of the condition. A positive association of HLA-DRB1*15 with Dupuytren's disease in Caucasians has been described.23 An increase in expression of the TGF β-2 gene has been demonstrated in cords from Dupuytren’s tissue.24 Several biomarkers have also been identified in Dupuytren’s tissue which may have implications in future diagnostics and treatments.25
A further recent and significant advance in the treatment of Dupuytren’s disease has been the development of enzymatic fasciectomy with clostridial collagenase. Hurst et al performed a prospective, randomised, double-blind, placebo-controlled, multicentre trial of collagenase from Clostridium histolyticum injection in 308 patients with Dupuytren’s disease, particularly with contractures of 20º or more. Collagenase injections were found to significantly reduce contractures and improve the range of movement in affected joints.26 An eight-year follow-up of a small subgroup of these patients showed recurrence of the disease in four of the six metacarpophalangeal joint (MCPJ) contractures treated and in both of the two PIPJ contractures, although the severity of recurrence in the MCPJ was less when compared with the initial disease.27
http://www.boneandjoint.org.uk/content/focus/current-treatment-dupuytren%E2%80%99s-disease-and-newer-advances
Posted Sep 10, 2017 by Jim 4055
