A new treatment for Dupuytren’s disease…and maybe cellulite?

It’s pretty cool when modern medicine comes up with a treatment that replaces or reduces the need for invasive surgery. In the case of Xiaflex, a new injectable treatment for people with Dupuytren’s disease, this may well be the case.

Dupuytren’s, by way of background, is a disease in which fibrous collagen-laden tissue builds up in the palm and fingers, creating nodules and cords. These cause the fingers to curl inward, making it difficult to straighten out the hand. It most commonly affects the ring and little fingers of the hand.

Until recently, a surgical procedure known as fasciectomy was the standard treatment, but it was plagued by issues of incomplete treatment, recurrence of the original contracture, potential for nerve injury, and other problems.

Recently, collagenase – an enzyme that breaks down collagen – was tried as a treatment for this problem, injecting the enzyme into the abnormal tissue. The collagenase enzyme is marketed under the name “Xiaflex”.

The good news: it works, helping about two-thirds of patients regain significantly improved motion in their hand. This is an injection performed in the office – talk about minimally invasive! The results of the study can be seen here, in the New England Journal of Medicine (link).

While I don’t perform hand surgery, I think this is a significant breakthrough.

Here’s the potential cosmetic application: injections of collagenase have been shown in a few preliminary studies, to be helpful for cellulite. Millions of women would love to improve their cellulite, right? This could be the next Botox, people!

So far, the company is only selling the product to hand surgeons and rheumatologists, and only for Dupuytren-specific applications. FDA approval for the other application is pending…

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