Table 5.
Literature review of chemonucleolysis with condoliase
| Author, year, Reference | Number of cases treated with condoliase | Mean age (years) | Sex (M/F) | Follow-up period (months) | Affected level (L1/2,L2/3,L3/4,L4/5,L5/S) | Serious adverse events*/ Allergy-like symptoms** | VAS for leg pain improved ≥ 50% *** | Surgery after injection | Comments |
|---|---|---|---|---|---|---|---|---|---|
| Matsuyama et al., 2018 15 | 115 | 39.2 (range NA) | 82/33 | 13 | 0/0/0/64/51 | 3/4 | 84 (73%) | NA | Incidence of adverse drug reactions and decrease in disc height were dose dependent |
| Chiba et al., 2018 7 | 81 | 39.5 (range NA) | 50/31 | 13 | 0/0/0/45/36 | 3/4 | 59 (73%) | 8 (10%) | At 1 year after administration, condoliase significantly improved symptoms in patients with LDH and was well tolerated |
| Nakajima et al., 2020 14 | 42 | 47.7 (range NA) | 29/13 | 3.2 | 0/2/2/23/15 | NA | 32 (76%) | NA | Most effective in cases with a larger herniated mass volume before treatment; least effective in cases with longer time before treatment |
| Ishibashi et al., 2020 13 | 34 | 32.4 (range 13–68) | 24/10 | 3 | 0/0/0/25/9 | NA | 21 (62%) | 6 (17%) | Improved leg pain significantly correlated with high-intensity signal change and size of protruded NP |
| Banno et al., 2021 9 | 47 | 48.0 (range 15–81) | 27/20 | 8.2 | 0/1/2/23/21 | NA | 33 (70%) | 1 (2%) | Efficacy in transligamentous type cases and those with high T2 herniation |
| Okada et al., 2021 11 | 82 | 47.2 (range 18–70) | 55/27 | 9.1 | 1/5/3/37/36 | 0/3 | 70 (85%) | 2 (2%) | Condoliase should be injected into the center of the intervertebral disc |
| Hirai 2021 19 | 52 | 45.0 (range NA) | 35/17 | 6.0 | 1/1/4/30/16 | 0/2 | 40 (76%) | 3 (5.8%) | Leg pain more likely to improve in patients with high-intensity signal change in the area of LDH |
| Banno et al., 2022 10 | 60 | 44.5 (range NA) | 37/23 | 22 | 0/1/4/26/29 | NA | 47 (73%) | 8 (13%) | Disc degeneration induced by chemonucleolysis can recover |
| Kobayashi et al.,2022 22 | 127 | 46.6 (range 16–88) | 88/39 | 9.8 | 2/6/6/66/47 | 0/3 | 95 (75%) | 16 (13%) | Progression of Pfirrmann grade on MRI significantly associated with improved clinical outcome |
| Matsuyama 2022 23 | 228 | 39.0 (range NA) | 115/73 | 45.8 | 0/0/0/121/107 | NA | NA | 31 (13.4%) | Follow-up > 1 year revealed no new safety concerns of condoliase |
| Banno 202224 | 67 | 46.7 (range NA) | 44/23 | 33.5 | 0/0/4/36/27 | 0/0 | 51 (76.1%) | 8 (12%) | Chemonucleolysis-induced disc degeneration slightly recovered and maintained for two years post-treatment |
| Takeuchi 2023 25 | 101 | 53.1 (range NA) | 80/21 | NA | 1/3/12/41/44 | 0/5 | 88 (87%) | 18 (17%) | Calcified or ossified disc herniation may be predictors of unsuccessful treatment |
Values are presented as number (%)
* A serious adverse event was any event that occurred during the study period (regardless of its relationship to the treatment) that resulted in death, was life-threatening, required inpatient hospitalization or prolongation of hospitalization for treatment, resulted in persistent or significant disability or incapacity, resulted in a congenital anomaly or birth defect, or caused other clinically significant events or reactions
** Drug eruption and rash
*** Baseline vs. 3 months after injection
NA: Not available