Dupuytren’s contracture (DC) is one of the many conditions we have experience treating at Center for Musculoskeletal Disorders. Last month, the U.S. Food and Drug Administration (FDA) approved increased usage of one of our treatment methods, a drug administered by injection.
Dupuytren disease, also called Dupuytren’s contracture or simply Dupuytren’s, is a progressive condition affecting the hand, specifically the layer of tissue just under the skin of the palm and fingers. While this layer of tissue normally contains collagen, in patients with DC there is an increase in the amount of collagen produced. Abnormal collagen build-up results in nodule and cord formation that worsens over time. Eventually, rope-like collagen cords may form, thicken and shorten, affecting the joints and causing the fingers to be drawn in toward the palm. This thickening and shortening of the Dupuytren’s cord can reduce the finger joint’s range of motion (how much a person can move or straighten them). Once the Dupuytren’s collagen cord can be felt, it is referred to as a “palpable cord,” and considered Dupuytren’s contracture. The disorder is most common in Caucasians and in men over age 50.
The small and ring fingers are specifically affected in DC. The main function of the palmar fascia is to increase the hand’s ability to grip; thus, over time, Dupuytren’s contracture decreases patients’ ability to do so. Pain, aching, and itching are also often symptoms reported by people diagnosed with Dupuytren’s.
There are 70,000 procedures to treat patients affected by DC every year. It is estimated that 35 to 40 percent of annual U.S. surgical procedures to treat DC have been performed to treat at least two DC joints at a time.
At the Center for Musculoskeletal Disorders, one of our DC treatments is XIAFLEX®. The FDA originally approved this drug for use in February 2010. XIAFLEX® (collagenase clostridium histolyticum) is a biologic drug made from the protein product of a living organism. It works by breaking down the excessive buildup of collagen in the hand.
XIAFLEX® is injected directly into the collagen cord of the hand. It should only be administered by a health care professional experienced with this kind of injection, which is one of the hallmarks of our practice. XIAFLEX® injections are one of several DC treatments, and are meant to be a preventative step in avoiding the eventual need for surgery.
In October 2014, the FDA expanded the approval of XIAFLEX® for the treatment of up to two Dupuytren’s contracture joints in the same hand during a single treatment visit. This will allow great flexibility in the scheduling process for treatment, which is beneficial for patients.
According to Auxilium Pharmaceuticals, the maker of XIAFLEX®, “We believe this marks an important milestone for patients and physicians as it expands their options for treating two joints concurrently in one office procedure, which may result in less overall treatment time.”
Dr. Michael Horowitz is highly skilled in the diagnosis and treatment of Dupuytren’s contracture. He and his staff pride themselves on their personalized approach, guaranteeing they meet the unique needs of individual patients. Now they can accommodate those with DC to an even greater degree. Make an appointment today.