Dupuytren’s disease, or Dupuytren’s contracture, is a deformity of one or more fingers caused by shortening, thickening and fibrosis of the connective tissue that lies under the skin in the palm of the hand. This leads ultimately to collagen cords that permanently contract the fingers, impeding the ability to grasp or manipulate objects. The disease is more common in men than in women, and the incidence rises progressively with increasing age.
Although Dupuytren’s disease is named for an eminent nineteenth century French surgeon, Baron Guillaume Dupuytren, who delivered a lecture describing an operation to treat the condition in 1831, the disease was well known long before this. The cause of the disease is not known, but it is often said to have originated with the Vikings who spread it as they invaded and settled new regions.
Surgical management has most commonly been used to release the contracture, although the disease can recur or even worsen following surgery, and there is a significant risk of nerve and/or arterial damage. A promising new treatment that has completed phase III clinical studies is the injection of collagenase which weakens the cords of connective tissue. Pfizer and Auxilium have recently announced a strategic alliance to develop XIAFLEX™ (injectable clostridial collagenase) for the treatment of Dupuytren’s contracture. It is expected that XIAFLEX™ will be filed for approval in the US in 2009 and in the European Union in 2010.