Sounds pretty much like what collagenase is used for. Is your Dr. participating in the phase III trial of collagenase?

Wolfgang

I am one of 216 national participants in the Phase III "AA4500 (XIAFLEX™, Proposed Name) in the Treatment of Dupuytren's Contracture (CORD-I)." I had the treatment on Nov.27 and the connective tissue was ruptured the next day. I was very luck to receive the AA4500 enzyme - as opposed to the placebo. Ihad a little swelling, which is mostly gone now. My bent finger lines up almost with the others. I sleep at night with hand brace to keep the finger from curling. This is a truly wonderful treatment. No one knows anything about re-occurence rate. But, compared to the NA treatment (50% within 5-years) I do not see how I can lose! This probably will not be licensed by the FDA for another two years. But, based on my success to date, I strongly recommend it and wish that it was available to all. You can read about the Phase III trials at http://www.clinicaltrials.gov/ct/show/NCT00528606?order=2.

Personally I don't see the cord completely dissolved by the injection. If that would be the case it would probably be very difficult injecting just the right amount of collagenase to dissolve this cord. You wouldn't like to inject excess amounts that move into the surrounding healthy tissue and joints. I think the process is that enough collagenase is injected to just weaken the cord and then snap it mechanically, like in NA. Actually I could imagine (no idea whether it really happens) that the enzyme injection makes the remainder of thhe cord a little more elastic. It then might happen that the cord does not snap but is extended. That would also get the finger straight but it then might (only might!) foster reccurrence. That's just speculation, we simply don't know enough how and don't have sufficient statistics. That's why this trial is so useful.

We all are tempted to imagine that collagenase dissolves the vicious Dupuytren cord and thus eliminates the disease. But collagenase can't tell the difference between good and bad collagen and it probably won't work as well on a nodule that consists to a higher degree of myofibroblasts, while the cord consists mainly of collagen.

Wolfgang

Hi webb, I am no physician, just another guy having Dups. I think it is really good that you heard the SNAP when your cord broke. I believe that's the way it ought to be. Just like NA. Congratulations! And thank you for reporting your experience and progress. We all feel with you!

Wolfgang

Edited at 11.12.07 16:14