Boy that's a great question ...this wonder site has some very learned folks that may be willing to offer advice.

In my humble opinion ..I do not feel Xiaflex has been around long enough to make a comparison..

There are no head to head studies available comparing both treatments. The definition of recurrence is not standardized and comparing publications using different definitions is diffcult. At the Dupuytren conference in Groningen this year Eva Baur presented a comparison between collagenase and needle fasciotomy but based on her clinic's experience only (http://www.dupuytrensymposium.com/program_2015.php , session 6). A larger study is still missing.

My personal feeling is that the original hopes that collagenase has a much longer recurrence period because the cord is partially dissolved by the enzyme, might not fully materialize. Collagenase might be a little better with respect to recurrence but not much. And, as you say, individually there is no way yet to predict recurrence.

The winner of the Dupuytren Award 2014, Clayton Peimer, analyzed recurrence data of collagenase http://www.dupuytren-online.info/dupuytren_award.html and found that for some patients the results are very stable while for others recurrence starts nearly immediately. Overall the authors state "The recurrence rate, which is comparable to other standard treatments, and the absence of long-term adverse events 3 years after initial treatment indicate that CCH is an effective and safe treatment for Dupuytren contracture."

With respect to correction both treatments are probably similar. NA might be better if you have to work on a difficult situation because you can continue to poke the cord until you reach the desired result. With collagenase it is injection and then wait and see. Collagenase might have advantages when you are treating disease in the webspace between fingers.

You might also have a look at the results of our Patient Survey http://www.dupuytren-online.info/patient_survey.html. There NA (also named PNF) gets better ratings than collagenae but data might be a little skewed in favor of NA because many patients from Charlie Eaton participated in the survey. And they just loved Charlie.

Wolfgang

Edited 11/23/15 08:24

Thanks for reply, feeling a bit down right now. want to get rt for my hand but pinky is at 18 degrees, so I have to get it straight first. Called my hand surgeon , she doesn't do na only xiaflex. she was concerned about not being able to go far enough up the fingers, she pointed to about an 1/8 down from first knuckle. Reason being tendon damage if she went to far. I wonder if the same applys to na? time to look for a new doctor, this is really frustrating, trying to stay ahead of this disease. I watched one of the video comparisons and lower tubianas was mentioned. Wach could you clarify what that is?

Edited 11/25/15 23:14