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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 randomised a total of 673 patients to receive an injection of Collagenase or surgery. Recruitment has now ended, but we are continuing to monitor Dupuytren’s contracture 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 July 2022.

Procedures have been put in place to continue participation in the DISC trial safely given the COVID-19 pandemic. All treatment and hospital visits will be conducted in-line with NHS guidance for COVID-19 prevention.

Written and visual guidance is available to explain why the research is being done, and what taking part will involve. If you are a current DISC participant please ask your local research team for a copy of the written information. The video is provided here for reference.

https://youtu.be/z2w-597Y6tA

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Photography Sub Study 

The DISC study is also looking to find out if finger extension can be measured from photographs rather than from an assessment in clinic.

Participants taking part in this sub-study will be asked to take photographs at the beginning (Baseline) and at 3 months, 6 months, 12 months and 24 months after receiving treatment, unless told otherwise by the local study team. 

Written and visual guidance on taking these images is available to participants. If you are a current DISC participant please ask your local research team for a copy of the written guidance. The video is provided here for reference.

https://youtu.be/LDO9ehfIG8o