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Table 2 Summary of results of pharmacological treatment

From: Systematic review of non-surgical treatments for early Dupuytren’s disease

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.

  1. 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