From my understanding, the procedure itself is unchanged for all the trial phases. The number of subjects and the study design are the only things than change. Phase III being the final, largest, most expensive and definitive.

If limited Collagenase injections were considered dangerous, the trials would not have gotten this far.

The idea is to inject just enough AA4500 to bio-mechanically weaken the cord(s) so it can be torn apart by stretching the fingers. This is *exact* thing that NA does, but fully mechanically with the sharp end of a syringe.

It would appear that the bio-mechanical approach (Collagenase) is more attractive to hand surgeons than NA. In spite of the data presented to the ASSH by Eaton et all showing NA's safety and effectiveness, it would appear that his colleagues are sitting on the sidelines awaiting AA4500 availability. It will be more expensive but perhaps easier for CHS to learn to use.

At the end of the day, surgeons really don't like cutting things they can't *see* and would prefer to inject an FDA approved material to do the same thing. However, because of the lower cost I believe NA is here to stay.

What is my take? I am hopeful. I really believe that AA4500 will become the treatment of choice for the non NA believing hand docs in the near future. I think 2 years is a reasonable goal. This latest setback is a small bump in the road. Capitalist greed will rule, as always. The stock will rise nicely. Think of this setback as a gift....a wonderful buying opportunity.