Table 2.
Summary of results of pharmacological treatment
| Author (year) treatment | Total cohort of DD patients (hands) | Number of patients (hands) with early DD | Study type | Level of evidence (OCEBM) Prospective (P) Retrospective (R) Not stated (N) | Outcome measure | Results | Recurrence | Adverse events | ||
|---|---|---|---|---|---|---|---|---|---|---|
| Improved | No change | Deteriorated | ||||||||
| Steroids | ||||||||||
| Baxter (1952) [30], Intramuscular | 11 (16) | 1 (2) | Case study | 5 (N) | Clinical observation of nodules, extension deficit | 0 | 1 | 0 | Not reported | Not reported |
| Oral | 1 (2) | Case study | 5 (N) | Clinical observation of palmar fascia | 0 | 1 | 0 | Not reported | Not reported | |
| Ketchum (2000) [31], Injection | 63 (75) | 63 (75) | Case series | 4 (N) | Nodule easier to inject and flatter | 62 patients (73 hands) | 0 | 1 patient (2 hands) | 50 % of patients at 1 to 3 years | 50 % patients reported transient depigmentation or temporary subcutaneous atrophy at injection site. ‘Nearly all’ resolved at 6 months |
| Clinically observed digital contracture | 0 | 62 patients (73 hands) | 1 patient (2 hands) | |||||||
| Shelley (1993) [32], Topical | 2 | 1 | Case study | 5 (N) | Contracture shrinkage | 1 | 0 | 0 | None at 2 years | Not reported |
| Zachariae (1955) [33], Injection | 11 (11) | 9 (9) | Case series | 4 (N) | Fibrosis diminished or softer | 9 | 0 | 0 | 1 at 14 months | Not reported |
| Coste (1953) [34], Injection | 9 (13) | 2 (2) | Case series | 4 (N) | Clinical observation of nodules, extension deficit | 2 | 0 | 0 | Not reported | Not reported |
| Vitamin E (oral) | ||||||||||
| Reilly (1974) [35] | 1 (2 hands) | 1 (2 hands) | Case study | 5 (N) | Clinical observation | 0 | 0 | 1 patient (2 hands) | Eventually required surgery in both hands | Not reported |
| Richards (1952) [36] | 70 hands | 63 hands | Case series | 4 (N) | Observation, deformity monitored using plaster cast moulds | 0 | 60 | 3 | Not reported | No toxic effects |
| Steinberg (1951) [18] | 22 | 6 | Case series | 4 (N) | Clinical observation | 6 | 0 | 0 | Not reported | Not reported |
| Other | ||||||||||
| Skliarenko (1982) [37], furazolidone injection | 98 | 74 | Case series | 4 (N) | Clinically observed digital contracture | 74 | 0 | 0 | 9 patients in total cohort (4 at 1 year, 3 at 2 years, 2 after 3 years) | 18 of total cohort of 98 reported minor hand swelling, raised temperature after 1st injection. No systemic side effects. |
| Gatev (1997) [38], Topical aminosyn and ultrasound | 63 | 22 | Cohort study | 4 (N) | Clinical observation of palm thickening, tension and trembling | 21 | 1 | 0 | Not reported | Not reported |
| Topical aminosyn | 4 | 4 | 0 | 0 | ||||||
| Ultrasound | 6 | 4 | 2 | 0 | ||||||
| Yildiz (2004) [39], Hyperbaric oxygen | 1 | 1 | Case study | 5 (N) | Extension deficit, clinical observation | 1 | 0 | 0 | None at 1 year | No adverse effects. |
Summary of results of pharmacological treatment from each study, including the number of patients with Dupuytren’s disease in the total cohort in each study, the number of patients with early disease within the total cohort, study type and design, level of evidence according to the Oxford Centre for Evidence Based Medicine (OCEBM) criteria, the outcome measure used and results. The number of hands (in brackets) is stated when available, with recurrence and adverse events where stated