The CeCORD-J study on collagenase injection versus aponeurectomy for Dupuytren's contracture compared by hand function and cost effectiveness
Michiro Yamamoto, Hideo Yasunaga, Ryosuke Kakinoki, Naoto Tsubokawa, Akimasa Morita, Katsumi Tanaka, Akinori Sakai, Toshikazu Kurahashi, Hitoshi Hirata, CeCORD J study Group, Hitoshi Hirata, Masahiro Tatebe, Michiro Yamamoto, Tetsuro Onishi, Katsuyuki Iwatsuki, Katsuhiro Tokutake, Hideo Yasunaga, Ryosuke Kakinoki, Kazuhiro Otani, Naoto Tsubokawa, Akimasa Morita, Katsumi Tanaka, Akinori Sakai, Kunitaka Menuki, Yoshiaki Yamanaka, Shiro Urata, Takeshi Oguchi, Toshikazu Kurahashi, Norimasa Iwasaki, Yuichiro Matsui, Hiroyasu Ikegami, Hiroaki Sakano, Tetsu Katsumura, Masao Nishiwaki, Toshikazu Tanaka, Yuichi Hirasé, Yuri Kanno, Hiroyuki Kato, Masanori Hayashi, Shohei Omokawa, Hideo Hasegawa, Hiroyuki Gotani, Yoshitaka Tanaka, Toru Sunagawa, Rikuo Shinomiya, Rhoji Kajiwara, Etsuhiro Nakao, Takanobu Nishizuka, Yasunori Hattori, Takaaki Shinohara, Kentaro Watanabe, Nobuyuki Okui, Hiroshi Koshima, Tsuyoshi Tajika, Hiroyuki Ohi, Yoshio Kaji, Eiichi Nagayoshi, Ataru Igarashi
Abstract
This study compared hand function and the cost-effectiveness of treatment between collagenase Clostridium histolyticum (CCH) injection and limited fasciectomy for patients with Dupuytren's contracture (DC). The CeCORD-J study is a prospective, multicenter, non-randomized controlled, observational study of two parallel groups. Participants were DC patients with multiple affected fingers, including flexion contracture of the proximal interphalangeal (PIP) joint. The primary outcome was the Hand10 score, as a patient-reported outcome measure (PROM). We set secondary outcomes of EQ-5D-5L (QOL) score, degree of extension deficit, and direct cost. Propensity score adjustment was used to balance differences in patient characteristics between groups. Participants comprised 52 patients in the Collagenase group and 26 patients in the Surgery group. There were no significant differences in the Hand10 and QOL scores between the two groups at 26 weeks. Mean direct cost was 248,000 yen higher in the Surgery group than in the Collagenase group. Extension deficit angle of the PIP joint was significantly larger in the Collagenase group at 26 weeks. Although the Collagenase group showed dominance in cost-effectiveness, there was no significant difference between the two groups in hand function at 26 weeks.