It sure would be nice to know. The Stanford Clinical Trials website says: "The purpose of these studies is to test whether AA4500 will dissolve and rupture (“pop”) the cord (tissue) causing the contracture of your finger..." The Jrnl of Hand Surgery reports on previous studies says "lyse and rupture."

don't know how typical my results are-- being left with skin tethers- but if it dissolved the cord it would seem to me one wouldn't have skin tethers remaining nor would one need to 'pop" it on second day visit-- it would already be 'dissolved'. I consulted with Dr. Denkler prior to the trial and he urged me to enter it. I've spoken to him since about NA to deal with my remaining skin tethers. Once more I have to say I don't understand the advantage of collagenase-- except for lack of scar tissue and *possible*-- not yet really proven lower rates of recurrence-- if one must then undergo NA to deal with the palm and tethered fingers.

Key wrote:
It would be nice to get a firm answer is the drug will dissolve the tissue to not. Have had NA twice now, and it works great, but it comes back in my case twice as fast. The problem then is having NA multiple times a few, so is the drug will dissolve the cords thats huge. I have had my NA by Dr. Denkler (He's Awesome) and his understanding is that it will dissolve the cords. Be nice to know one way or the other.

cheers

I actually have 2 unanswered questions about Xiaflex.


1. What's the real reason for not just injecting more and more, until the cord is dissolved and full release is obtained? Can it damage surrounding tissue or does it just cost too much?

2. Will Auxilium be able to hold the price at $1,000 per injection or will insurance companies beat them down?

My feeling is for someone like myself, that has this disease in a very progressive state the shot is the next best option. If you have never had dupuytrens then NA in my option is the best option. it absolutely works the recovery is about a day or less and with almost no pain.

My Catch-22 is while NA works, I probably need it about 2x a year, maybe more and without insurance to cover it, and it only gets more progressive the shot is my "hope" for a longer term cure.

I would love to hear from anyone that has had multiple operations and NA and if there is any other procedure that might be worth looking at for a very progressive case.

Cheers

Thanks! I will take a look and I'm open to all options. I surgery (1st) in 98, then again in 02, same finger. Then had NA in 06 (by Dr. Denkler) little finger and ring finger. Worked very well but in 6months the relapse had began, then had NA again in 07 on the same fingers. Now here in O8, its back and by far the most progressive its been. Like I said for someone who got this young it can be so progressive.

thanks!

I was in the Safety / Efficacy study of AA4500. I was told that I had extra thick chords. My chords did not snap until after the third injection. I was told that under the study I was limited to only three injections. As far as "disolving" the chords, that is what I was told occured by the doctor. In essence, meat tenderizer is being injected into the chord to weaken it. The tenderizer is given 24 hrs to do its thing and is then streched to "snap" the chord. If the chord is extra thick, additional treatments are necessary. There was a 30 day window between injections. Swelling and pain from the injection subsided within days of the injection. I believe that the 30 days was to allow surrounding tissue to recover from enzyme that 'leaks' from the chord. The skin surrounding the injection site definitely has changed. It seems 'different'. I am now about 120 days past the first injection. I am happy with the results. Hopefully the trials will be complete and it will be available locally by the time my other hand is bad enough to need treatment.