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05/17/2005 23:28
Richard 
05/17/2005 23:28
Richard 
August beginning for phase III trial?

Like several of you, I have been waiting for years for the phase III trial to begin. I recently corresponded by email with Dr. Hentz, who wrote on 5/11 that, "A recent communication indicates that drug might be available by August." This doesn't sound as convincing as the news regarding the trial posted in an earlier message.

05/17/2005 23:50
jim h

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05/17/2005 23:50
jim h

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Naive Question

By "available" I'm guessing he meant available for the trials. Even if Phase III completed tomorrow, actual marketing would be a long ways off.

05/18/2005 23:06
Stage One

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05/18/2005 23:06
Stage One

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Naive Question

What is the perceived advantage of having collagenase injections to allow "snapping" DD/DC chords? Is it the
U.S. delivery site? Now that Dr. Eaton and others are
offerring NA in the US, has the "demand" for collagenase
decreased? I am curious. If a remedy exists and is effective
for similar cost and outcomes, what are the issues?
Pros and cons anyone? Neither approach is a cure.
Thanks and apologies to LD, PD sufferers, who may truly
benefit from Biospecific applications. They do not "need"
NA. They do deserve support from the larger community IMO.

05/18/2005 23:13
Michael

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05/18/2005 23:13
Michael

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collegenase

Many seem to believe that Collegenase could be used soley for release of contracture. That's not true. The clinical trials are focused on contracture release, but that won't prevent it from being used in other ways.

On my recent appointment with Dr. Denkler, we discussed Collegenase. In his opinion, there's no reason why, once it has passed trials, Collagenase couldn't be used a low dosages to clear Dup's out prior to contracture - which gives it a clear advantage over NA. Plus, Collegenase is already widely known and accepted by hand surgeons.

- MML


05/18/2005 23:30
Tolucca

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05/18/2005 23:30
Tolucca

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The Best We now Have

Assuming Auxilium is not using Collegenase as investor bate, and that approval for Peyronie's is achieved first, what about the fact that, once approved, many drugs are used "Off Label" once other uses for them are discovered. Neurontin is a good example. Approved as an anti seizure med, it is now used primarily for nerve pain. Will the FDA care where you inject the Collegenase once approved for PD? Surgeons want this option for DD, and if allowed to use it legally, they would.

I doubt Auxilium is aware of the NA movement, as it is really limited, for the most part, to this site. Five US surgeons offering it is nothing. There is no buzz yet. That will not happen until Eaton presents in 2006.

Where NA is effective, there is no advantage over Collegenase I can think of. However, I'd love a Collegenase injection of two to dissolve these painful Dups tissue in my palm.

05/18/2005 23:00
j

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05/18/2005 23:00
j

not registered

The Best We now Have

I think it might be used off-label for Dupuytren's, but hand surgeons would have to be the ones to do it. Given their generally dismissive attitude to the NA procedure (an attitude which my surgeon shared) they're less likely to invest time and effort investigating the use of Collagenase if it hasn't been through FDA trials for that purpose.

One objective of the trials is to establish that a drug does no harm; another is to determine the optimum dosage or means of application. Without trials for DC, hand surgeons would be left to work those things out on their own; a risk that many would be unwilling to take.

It's all academic, anyway, at this point. Even if they're serious, it would take years. Something better might come along before then.

05/19/2005 23:50
Toluck

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05/19/2005 23:50
Toluck

not registered

The Best We now Have

Well J, as many of us know "first Hand", something has---> NA. In spite of it's limitations and drawbacks, at least the World is finally going to have it's first meaningful alternative to OS in 50 years. While I'm greedy for more and better options, at least we can count NA among our blessings on our still fully operational fingers.

05/19/2005 23:32
jim h

not registered

05/19/2005 23:32
jim h

not registered

Ledderhose - NA

Yes NA appears to work, but at this point you have to travel to Florida (or Europe) at your own expense.

And it won't help people with Peyronie's or Lederhose. Which, by the way, already affect some of the posters on this forum, or will in the future.

05/19/2005 23:39
Graeme

not registered

05/19/2005 23:39
Graeme

not registered

Ledderhose - NA

For Jim h

I am a member of Ledderhose - Yahoogroups.com
I posted details of the Paris practioners on this site. Shortly after my posting a lady from Portugal posted that as a result of my info. she had postoned foot surgery for her son and instead got him into Dr Lermusiaux. Lermusiaux performed NA on his foot. She wrote that her son walked out of Lermusiaux's door without any discomfort and was thrilled with the results and the fact there was no tradtional surgery. Another convert!!

05/19/2005 23:17
jim h

not registered

05/19/2005 23:17
jim h

not registered

Ledderhose - NA

I've heard a couple reports of NA for Ledderhose but have sort of dismissed them because I don't see how it would help. With DC there is a cord that can be snapped, released the joint. Ledderhose is just a lump of fibrous tissue under the arch - there's no cord and no contracture. The problem is just the discomfort and pain caused by putting weight on it. NA techniques might be used to break it up somewhat but it's hard to see how that would be of much help.

Maybe I'm missing something here and I'd like to hear the details of such a procedure.

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