NICE is consulting on its provisional recommendations on a treatment for Dupuytren’s contracture, where fingers gradually bend in towards the palm of the hand and cannot be straightened. 

The NICE independent Appraisal Committee examined the clinical and cost effectiveness of using collagenase clostridium histolyticum (Xiapex) for treating Dupuytren’s contracture in adults.  The draft guidance proposes to not recommend collagenase clostridium histolyticum (CCH) for this use.   Adults who are currently having NHS treatment with CCH for Dupuytren’s contracture should be able to continue treatment until they and their clinician decide to stop. This draft recommendation is now open for consultation – NICE has not yet issued guidance to the NHS.

Dupuytren’s disease is a progressive condition which affects fingers and the hand. It occurs when collagen – the fibrous protein in the connective tissue in the hand – thickens to form a small lump, or ‘nodule’.  This collagen nodule may then form cords of tissue, which can contract and pull the finger in towards the palm.  As the disease progresses the fingers can become fixed in a bent position. When the fingers cannot be straightened, the disease is called Dupuytren’s contracture. The condition can limit a person’s ability to use their hand, cause pain and affect routine daily activities.  CCH is given as an injection into the collagen cord. The collagenase enzymes in the treatment break down the collagen fibres which weakens the cords, and then a procedure to extend the finger can be performed.

For more details, go to: https://www.nice.org.uk/news/press-and-media/nice-consults-on-treatment-for-finger-contracture-caused-by-dupuytrens-disease