Injectable Mixed Collagenase Shows Good Results in Dupuytren's Contracture: Presented at AAOS

By Jill Stein

SAN DIEGO, CA -- February 16, 2007 -- AA4500, an injectable mixed collagenase, might be a treatment option for patients with Dupuytren's contracture, according to phase 3 results presented here at the 2007 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Lawrence G. Hurst, MD, chairman, orthopaedics division, Stony Brook University Hospital, Stony Brook, New York, and associates tested the efficacy and safety of AA4500 for the treatment of flexion deformities of at least 20 degrees in metacarpophalangeal (MP) and/or proximal interphalangeal (PIP) joints.

Patients who completed a double-blind, placebo-controlled phase following randomization were eligible to enter an open-label extension phase.

The primary efficacy endpoint was overall clinical success, defined as a reduction in deformity to within 0 degrees (normal) to 5 degrees (flexion) of normal (0 degrees) within 30 days of the last injection for the primary joint.

Patients were followed for 1.6 years after the last injection.

Overall, 33 (94%) of 35 patients who entered the double-blind phase completed the study. Nineteen of these patients entered the open-label extension phase.

In the double-blind phase, the clinical success of the primary joint was achieved in 70% of 23 patients who had received 1 injection and 91% of 23 patients who had received 3 injections of AA4500, Dr. Hurst said in his presentation on February 16th.

No placebo-treated patients achieved joint correction.

Among the 19 patients in the open-label extension, 89.5 % achieved clinical success in at least 1 joint.

Of 31 MP and 31 PIP joints that were treated in 35 patients, 87% joints were rated as clinical successes.

Contracture recurrence developed in 5 joints -- within 12 months in 2 cases and at 12 months in 3 cases.

Adverse events were localized to the injection site and were usually of mild to moderate severity and transient.

Dr. Hurst said that the data are in line with findings from phase 2 studies and provide additional evidence for the effectiveness of AA4500 as a nonsurgical treatment for Dupuytren's contracture.

A range of nonsurgical treatments have been evaluated for Dupuytren's contracture including radiotherapy, ultrasonic therapy, and gamma interferon injections, among others.

The study was supported by BioSpecifics Technologies Corp.


[Presentation title: Long-Term Safety and Efficacy of Injectable Mixed Collagenase for Dupuytren's Disease: Phase 3 Trials. Abstract 369]

Hi -I was diagnosed with dupuytren`s april 05-and have just started to experience pain in my right shoulder-the old bio-specifics threads mention the usefulness of swimming as therapy-and I`ve also discovered the Neil-Asher technique.
http://www.frozenshoulder.com/

Has anyone tried this-it seems like a well thought out natural approach to the problem.
In the meantime-I`m heading for the local swimming pool to give that a try-got to keep all my joints moving since I`m a professsional musician!!!It seems this disease keeps you on your toes on all fronts-viz feet, hands. shoulders and of course your
essential manhood!!

Hi again Wolfgang-learning about the frozen shoulder link seems to shed a bit on light on how I might have inherited DUPS.No one in my family I know has suffered dups or LH -but my dad did suffer from frozen shoulder so there could be a link there.Glad to hear you overcame your shoulder problems - I`m about to get busy on mine before things take a turn for the worse.On the dups and LH, I think the NAC is beggining to have a beneficial effect after 6 weeks or so -though I believe from your former posting it takes a little longer for its benefits to work through.I`ll keep the forum posted as we go!!

Hi Again Wolfgang-I would be delighted to participate in the proposed survey on the efficacy or otherwise of NAC.Interesting that Radiotherapy and NAC are both therapies that are based in and being developed/tested in Germany.I`m very pleased I can access this information and treatment quite easily as a person living in the UK.Does anyone know what happened to the old acetyl- L- carnetine survey-or is that all outmoded now by the NAC...

Hi Again-on the Frozen Shoulder-mine has just entered the first pase-restricted movement behind my back-and a little pain in challenging the restriction.At the moment,symptoms are only apparent in the right shoulder and not too painful with no difficulty yet in playing musical instruments.I have contacted a Neil- Asher Osteopath who fortunately practises close to Oxford.I`ll keep you posted on progress with this therapy.The results on the website certainly look impressive--

http://www.frozenshoulder.com/

As with all therapies you don`t really know until you give it a go!!