Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review

Abstract Introduction Collagenase Clostridium Histolyticum (CCH) has become a therapeutic alternative for Dupuytren disease. However, its efficacy in the medium to long term is unknown. The objective of our study is to carry out a systematic review of the studies conducted on the subjec...

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Main Authors: Rafael Sanjuan-Cerveró, Pedro Vazquez-Ferreiro, Diego Gomez-Herrero, Francisco Javier Carrera-Hueso
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2017-11-01
Series:Revista Iberoamericana de Cirugía de la Mano
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1608749
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author Rafael Sanjuan-Cerveró
Pedro Vazquez-Ferreiro
Diego Gomez-Herrero
Francisco Javier Carrera-Hueso
author_facet Rafael Sanjuan-Cerveró
Pedro Vazquez-Ferreiro
Diego Gomez-Herrero
Francisco Javier Carrera-Hueso
author_sort Rafael Sanjuan-Cerveró
collection DOAJ
description Abstract Introduction Collagenase Clostridium Histolyticum (CCH) has become a therapeutic alternative for Dupuytren disease. However, its efficacy in the medium to long term is unknown. The objective of our study is to carry out a systematic review of the studies conducted on the subject. Material and Methods Systematic bibliographic search. Analysis depending on the time of progression, looking into 2 groups with the follow-up cut-off point of 1 year. Analysis of the number of patients who reached the primary endpoint, of the mean correction in degrees, and of the proportional correction of each joint. Results The 50 selected clinical trials encompass a total of 4,622 patients (an average of 92.70). A total of 7,546 joints were treated with the mean being 148.15 joints per trial (3,925 metacarpophalangeal [MCP] and 2,350 proximal interphalangeal [PIP]). In less than one year of progression, the primary end point was reached in 48.9% of the joints (69.77% of the MCPs and 30.14% of the PIPs), the mean correction in degrees was 45.5 (standard deviation [SD]: 19.18) degrees; 40.8 degrees in the MCP (SD: 10.12) and 35.6 in the PIP (SD: 13.23), and the proportional correction of the joints was 72.9% (SD: 14.43) (83.9% for MCPs [SD: 12.58] and 64.2 for the PIPs [SD: 16.35]). In the follow-ups over 1 year, the primary end point was reached at a rate of 57.5% (68.9% of the MCPs and 43.3% of the PIPs), the mean correction in degrees was 37.6 degrees (SD: 10.93) (37.3 degrees in the MCPs [SD: 9.98] and 23.7 in the PIPs [SD: 16.33]) and the proportional correction of the joints was 87.3% (SD: 10.96) (90.3% for MCP [SD: 6.94] and 75% for PIP [SD: 13.54]). Conclusions The results indicate a satisfactory response to CCH treatment maintained in the short and medium term. The recurrence rate is uncertain given the available data.
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spelling doaj.art-84e53f295a744eed9c90d14010a70db42022-12-22T03:39:04ZengThieme Revinter Publicações Ltda.Revista Iberoamericana de Cirugía de la Mano1698-83961698-840X2017-11-01450207008810.1055/s-0037-1608749Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic ReviewRafael Sanjuan-Cerveró0Pedro Vazquez-Ferreiro1Diego Gomez-Herrero2Francisco Javier Carrera-Hueso3Department of Orthopedics and Traumatology Surgery, Hospital de Dénia, Alicante, SpainDepartment of Ophthalmology, Hospital Virxe da Xunqueira, La Coruña, SpainPharmacy Service, Hospital 9 de Octubre, Valencia, SpainPharmacy Service, Hospital Dr. Moliner, Valencia, SpainAbstract Introduction Collagenase Clostridium Histolyticum (CCH) has become a therapeutic alternative for Dupuytren disease. However, its efficacy in the medium to long term is unknown. The objective of our study is to carry out a systematic review of the studies conducted on the subject. Material and Methods Systematic bibliographic search. Analysis depending on the time of progression, looking into 2 groups with the follow-up cut-off point of 1 year. Analysis of the number of patients who reached the primary endpoint, of the mean correction in degrees, and of the proportional correction of each joint. Results The 50 selected clinical trials encompass a total of 4,622 patients (an average of 92.70). A total of 7,546 joints were treated with the mean being 148.15 joints per trial (3,925 metacarpophalangeal [MCP] and 2,350 proximal interphalangeal [PIP]). In less than one year of progression, the primary end point was reached in 48.9% of the joints (69.77% of the MCPs and 30.14% of the PIPs), the mean correction in degrees was 45.5 (standard deviation [SD]: 19.18) degrees; 40.8 degrees in the MCP (SD: 10.12) and 35.6 in the PIP (SD: 13.23), and the proportional correction of the joints was 72.9% (SD: 14.43) (83.9% for MCPs [SD: 12.58] and 64.2 for the PIPs [SD: 16.35]). In the follow-ups over 1 year, the primary end point was reached at a rate of 57.5% (68.9% of the MCPs and 43.3% of the PIPs), the mean correction in degrees was 37.6 degrees (SD: 10.93) (37.3 degrees in the MCPs [SD: 9.98] and 23.7 in the PIPs [SD: 16.33]) and the proportional correction of the joints was 87.3% (SD: 10.96) (90.3% for MCP [SD: 6.94] and 75% for PIP [SD: 13.54]). Conclusions The results indicate a satisfactory response to CCH treatment maintained in the short and medium term. The recurrence rate is uncertain given the available data.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1608749collagenaseclostridium histolyticumefficacysystematic review
spellingShingle Rafael Sanjuan-Cerveró
Pedro Vazquez-Ferreiro
Diego Gomez-Herrero
Francisco Javier Carrera-Hueso
Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
Revista Iberoamericana de Cirugía de la Mano
collagenase
clostridium histolyticum
efficacy
systematic review
title Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
title_full Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
title_fullStr Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
title_full_unstemmed Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
title_short Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review
title_sort efficacy of collagenase clostridium histolyticum for dupuytren disease a systematic review
topic collagenase
clostridium histolyticum
efficacy
systematic review
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1608749
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AT diegogomezherrero efficacyofcollagenaseclostridiumhistolyticumfordupuytrendiseaseasystematicreview
AT franciscojaviercarrerahueso efficacyofcollagenaseclostridiumhistolyticumfordupuytrendiseaseasystematicreview