Collagenase clostridium histolyticum in patients with Dupuytren's contracture: results from POINT X, an open-label study of clinical and patient-reported outcomes

摘要

In POINT X, a study designed to reflect clinical practice and patient treatment choices, 254 European patients received open-label collagenase for Dupuytren's contracture. The most severely affected joint was treated first in 74 of patients. In total, 52, 41, 7, and 1 of patients selected the little, ring, middle, and index finger, respectively; 79 had one or two joints treated. Only 9 of patients (n = 24) received 4 or 5 injections. The mean improvement in total passive extension deficit (TPED) was 34 degrees on day 1, improving further by day 7 to 42 degrees. This secondary improvement was maintained by day 90 and month 6. The mean number of injections/joint was 1.2 for the metacarpophalangeal joint and 1.25 for the proximal interphalangeal joint. Median time to recovery was 4 days; the mean improvement in hand function was clinically relevant as measured by the Unite Rhumatologique des Affections de la Main (URAM) score. In total, 87 and 86 of patients and physicians, respectively, were very satisfied or satisfied with treatment at month 6, although correlation between TPED and patient satisfaction was weak (Spearman -0.18, 95 CI -0.32 to -0.06). Collagenase was well tolerated, with 10 (3.9) patients experiencing severe adverse events. As a real-world study, the POINT X findings can be generalized to the at-large population.