Dupuytren disease is a common fibro-proliferative disease of the palmar fascia. Two collagenase clostridium histolyticum collagenases, in combination (AUX -1 and AUX-2), have been approved for the treatment of adult patients with a palpable cord. This study assessed the efficacy of this combination for the treatment of Dupuytren nodules.

Subjects with palpable palmar Dupuytren nodules were randomized to receive a placebo or collagenase clostridium histolyticum (CCH) at 0.25 mg, 0.40 mg or 0.60 mg. All were instructed to massage the nodule twice a day until week four. The participants were followed at weeks one, four and eight for assessments of the nodule.

At week four, the nodular surface area had decreased more in the treatment groups than in the placebo group for groups with CCH concentrations of 0.40 mg (P<0.01) and 0.60 mg (P＝0.0003), but not 0.25 mg (P＝0.08). Nodular hardness improved significantly in all treatment groups as compared with controls. The most common adverse events in the treatment group were contusion/bruising, extremity pain and localized swelling. Severe injection site pain was reported by one patient receiving 0.60 mg.

This study of patients with Dupuytren nodules found that a single injection of CCH can improve the size and hardness of palmar nodules.