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Collagenase Clostridium Histolyticum for Dupuytren's Contracture: Comparing Single and Concurrent Injections
Jonathan Cook1, Jessica Waughtel1, Anthony R Andreoni1
1From the Department of Plastic Surgery, Cleveland Clinic Florida; the Department of General Surgery, Mount Sinai Medical Center; and the Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle.
Concurrent collagenase clostridium histolyticum injections for Dupuytren's contracture show similar efficacy and safety to single injections. Lymphadenopathy was more common with concurrent treatments, but skin tears were not significantly different.
Area of Science:
- Orthopedics
- Hand Surgery
- Pharmacology
Background:
- Collagenase clostridium histolyticum (CCH) approved for Dupuytren's contracture (2010) and concurrent treatment (2014).
- Limited comparative data exists for concurrent versus single CCH injections.
Purpose of the Study:
- Compare clinical outcomes and adverse events of concurrent CCH injections versus single injections.
- Evaluate safety and efficacy of treating Dupuytren's contracture with multiple CCH injections simultaneously.
Main Methods:
- Retrospective cohort study of 121 concurrent and 177 single CCH injections over 8 years.
- Single surgeon performed all injections.
- Compared clinical success, contracture reduction, and adverse events (skin tears, lymphadenopathy, etc.).
Main Results:
- No significant difference in clinical success rate or contracture reduction between concurrent and single injections.
- Skin tear rates were similar (22.3% concurrent vs. 18.6% single) and not dose-dependent.
- Higher incidence of lymphadenopathy observed in the concurrent injection group (p=0.001).
Conclusions:
- Concurrent CCH injections offer comparable safety and efficacy to single injections for Dupuytren's contracture.
- No dose-dependent relationship found between CCH amount and skin tears.
- Lymphadenopathy is a notable adverse event in concurrent CCH therapy.
