Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 219.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26330801
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Hand+(N+Y)
2015 ; 10
(3
): 578-82
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Delayed manipulation after collagenase clostridium histolyticum injection for
Dupuytren contracture
#MMPMID26330801
Kaplan FT
; Badalamente MA
; Hurst LC
; Merrell GA
; Pahk R
Hand (N Y)
2015[Sep]; 10
(3
): 578-82
PMID26330801
show ga
BACKGROUND: Collagenase clostridium histolyticum (CCH) injection for Dupuytren
contracture was approved in the USA in 2010. Current FDA guidelines stipulate
that finger manipulation occurs the day following injection. To investigate the
safety and efficacy of delaying manipulation to 2 or 4 days following CCH
injection, we conducted a prospective, randomized trial at two sites. METHODS:
Patients with Dupuytren contracture involving the metacarpophalangeal (MCP) joint
?20° caused by a palpable cord participated. All patients received one dose of
CCH (0.58 mg/0.25 ml) and were followed for 90 days. The primary end point was
the percent of patients maintaining clinical success (reduction of contracture to
0°-5°) at 90 days post-injection. Adverse events and change in Michigan Hand
Questionnaire (MHQ) score were recorded as secondary end points. RESULTS:
Thirty-seven patients enrolled; 13 were manipulated on day 1, 11 on day 2, and 13
on day 4. At 30 days after injection, the percentage of patients obtaining
reduction of contracture to <0°-5° extension was 92, 82, and 85 % in groups 1, 2,
and 3, respectively, with no significant difference. At 90 days follow-up, the
percentage of patients maintaining 0°-5° extension was 91, 82, and 83 % in groups
1, 2, and 3, respectively, with no significant difference. Adverse events were
comparable to rates in prior studies. There were no serious adverse events. There
was no statistical difference in MHQ scores between groups at any time point.
CONCLUSIONS: Delaying manipulation to day 2 or 4 following CCH injection for MCP
joint contractures does not increase adverse events or result in loss of
efficacy. LEVEL OF EVIDENCE: Therapeutic, Level II.