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Review
. 2015 Feb;40(2):141-9.
doi: 10.1177/1753193414528843. Epub 2014 Apr 2.

Safety and tolerability of collagenase Clostridium histolyticum and fasciectomy for Dupuytren's contracture

C A Peimer  1 , S Wilbrand  2 , R A Gerber  3 , D Chapman  4 , P P Szczypa  5
Affiliations
Review

Safety and tolerability of collagenase Clostridium histolyticum and fasciectomy for Dupuytren's contracture

C A Peimer et al. J Hand Surg Eur Vol. 2015 Feb.

Abstract

Safety was evaluated for collagenase Clostridium histolyticum (CCH) based on 11 clinical trials (N = 1082) and compared with fasciectomy data in a structured literature review of 48 European studies (N = 7727) for treatment of Dupuytren's contracture. Incidence of adverse events was numerically lower with CCH vs. equivalent complications from fasciectomy (median [range] incidence), including nerve injury (0% vs. 3.8% [0%-50+%]), neurapraxia (4.4% vs. 9.4% [0%-51.3%]), complex regional pain syndrome (0.1% vs. 4.5% [1.3%-18.5%]) and arterial injury (0% vs. 5.5% [0.8%-16.5%]). Tendon injury (0.3% vs. 0.1% [0%-0.2%]), skin injury (16.2% vs. 2.8% [0%-25.9%]) and haematoma (77.7% vs. 2.0% [0%-25%]) occurred at a numerically higher incidence with CCH than surgery. Adverse events in CCH trials not reported after fasciectomy included peripheral oedema; extremity pain; injection site pain, haemorrhage and swelling; tenderness; pruritus and lymphadenopathy. CCH-related adverse events were reported as predominantly injection-related and transient. These results may support clinical decision-making for treatment of Dupuytren's contracture.

Keywords: Collagenase Clostridium histolyticum; Dupuytren’s contracture; fasciectomy; safety.

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Conflict of interest statement

Conflict of interests:

  1. Dr Peimer has received honoraria and travel reimbursements from Pfizer and Auxilium.

  2. Dr Wilbrand is a study investigator for Auxilium Pharmaceuticals and has received honoraria and travel reimbursements from Pfizer and Auxilium for consultancies.

  3. Drs Gerber and Szczypa and Mr Chapman are full-time employees of Pfizer.

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