Dupuytren's Interventions: Surgery vs Collagenase Trial (DISC)

Dupuytren’s contracture is the fourth most common problem affecting the hand in the UK. The disorder is caused by fibrous tissue, which forces the finger to bend down into the palm. Although it is rarely painful, patients cannot straighten the finger and this increasingly interferes with hand function.

The usual treatment for Dupuytren's contracture is to have surgery to straighten the bent finger. An alternative to surgery is a newly introduced collagenase injection, which softens the fibrous tissue that causes the condition, given in the clinic. The patient is followed up a few days later in clinic and the finger is manipulated, in an attempt to straighten it.

It is currently not known if the injection is as good or as safe as surgery at correcting finger deformity and if the correction is maintained in the long term. We also do not know whether the complication rates are similar. This study will find out how best to treat Dupuytren’s Contracture and if collagenase injections are as good and as safe as surgery for treating this condition.

The study aims to randomise 710 patients to receive an injection of Collagenase or surgery. Dupuytren’s contracture will be monitored before and after treatment. The primary outcome for the study will be Patient Evaluation Measure at 1 year post treatment to assess the impact of the correction on function.

The study is being run by the University Hospitals of Leicester (UHL) and the University of York, with funding from the National Institute for Health Research Health Technology Assessment Programme (Ref:15/102/04). Professor Joseph Dias at UHL is the Chief Investigator. The study started in October 2016 and is scheduled to end in October 2021.

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