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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
Lead Author: Dr Miriam Brazzelli
Contractor: University of Aberdeen
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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