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HTA - 13/05/01

Collagenase clostridium histolyticum for the treatment of Dupuytren's contracture (ID621)

Project title: Collagenase clostridium histolyticum for the treatment of Dupuytren's contracture (ID621)

Call to action: 14/87 Batch 29

Research type: Evidence Synthesis

Chief investigator: Dr Miriam BrazzelliORCID logo https://orcid.org/0000-0002-7576-6751

Lead Author: Dr Miriam Brazzelli

Contractor: University of Aberdeen

Cost: £210,000.00

Started: October 2013 | Status: Published November 2015

This study could not identify any randomised controlled trials (RCTs) or high-quality comparative studies assessing collagenase versus surgical interventions for the treatment of patients with Dupuytren’s contracture (DC). Collagenase has demonstrated to be superior to placebo in short-term RCTs, with better results for metacarphophalangeal than proximal interphalangeal joints. It is unclear whether or not collagenase can be used as a second-line treatment for DC. Based on the current evidence, collagenase does not appear to be the most cost-effective option to treat moderate to severe DC in people considered to be suitable candidates for surgery. Other surgical treatments appear more cost-effective, with limited fasciectomy (a type of surgery) being the most cost-effective choice. However, there are uncertainties in the data used for the economic evaluation. There is a need for sound clinical studies to compare the effects and costs of collagenase injections with those of surgical treatments.

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