AB117. 197. The management of Dupuytren’s disease with collagenase in an Irish population

Background: Collagenase clostridium histolyticum was first introduced for the treatment of Dupuytren’s disease in 2010. It is now widely used in practice with a success rate of 44–66% with a low rate of serious adverse events. There is a recurrence rate of up to 47% and currently little is known about patient factors associated with increased risk of recurrence or failure of treatment. To assess the efficacy and risk of collagenase treatment in treating Dupuytren’s disease in an Irish population and assess factors that may predict poor clinical response following treatment.

Methods: A retrospective review was carried out on patients treated with collagenase. Forty-four patients (81 affected fingers) over a 2-year period were included. Range of motion before treatment, at day 1 and day 90 were measured. Improvement in range of motion, complications, recurrence rates and failure were recorded.

Results: Mean age was 65.8 years old; mean time to presentation was 78.8 months. Seventy-three percent had involvement of one finger, 19% two-finger involvement. Sixty-two percent were treated successfully (defined as contracture <5˚ after injection). Nine percent required operation after injection. Greatest improvement was seen in the little finger metacarpophalangeal joint with a mean improvement of 43˚. Diabetes, epilepsy, gender, alcohol status or family history had no effect on successful outcomes with treatment.

Conclusions: The Irish population have similar success rates at described in the literature. We have established that common risk factors associated with Dupuytren’s are not associated with altered outcomes. Metacarpophalangeal joints tend to respond better to treatment with greater improvements in contracture.

Keywords: Dupuytren’s; contracture; treatment; collagenase; outcome