Nodular Shrinking in Dupuytren Disease
Nodular Shrinking in Stage 0 Dupuytren Disease: an Evidence-based Approach for Early Stage Treatment to Prevent Progression to Advanced Finger Contractures
Universitaire Ziekenhuizen KU Leuven
80 participants
Feb 15, 2024
INTERVENTIONAL
Conditions
Summary
Dupuytren disease (DD) is a common hand disorder with disabling finger contractures that may require surgery to restore function. In the early stages of the disease, the nodules (Tubiana stage 0) are usually painless, but a reason for concern to many patients. Not rarely, lifestyle measures and even risky treatment options as radiotherapy are advised, yet no therapy to prevent disease evolution has a solid proven effect. Furthermore, reliable non-invasive measurement of early stage DD is not validated. Evidence was found that pharmacotherapy may influence DD evolution, but valuable clinical trials are limited. Case series and non-published explorative follow-up suggested local treatment with antioxidant vitamin E to possibly interfere with an evolution of DD nodules to contracting strands. This study aims to provide evidence on efficiency of this non-invasive treatment option. Secure measurement of nodule evolution is a clinical challenge. To measure this evolution, ultrasound and MRI scanning are currently being performed. Stage 0 (nodules) is more challenging to quantify. A strict individual follow-up by the treating clinician is needed to standardize measurement of selected (treated) nodules. Therefore, simple ultrasound by the treating clinician may provide an good tool to collect data. This study aims to introduce and validate this non-invasive scan method and provide a prospective double blind investigation of a measurable effect of non-invasive preventive treatment for stage 0 DD to improve clinical outcome.
Eligibility
Inclusion Criteria4
- The participant or his/her legally authorized representative voluntary signed the informed consent prior to the first assessment.
- Participants are ≥ 18 years and diagnosed with primary Dupuytren disease.
- Included patients have a stage 0 DD (nodule of at least 5 mm in the involved hand without contracture).
- The participant has well distinguished noduli that are clearly visible on US (ultrasound)
Exclusion Criteria6
- Patients < 18 years.
- Patient included in an interventional trial with an investigational medicinal product.
- Patients with cognitive impairments, severe rheumatic disease and neurological disorders leading to flexion deformities of the fingers.
- Patients with prior Dupuytren surgery in the involved hand.
- Patients with a higher Tubiana grading than nodular stage 0.
- Open wound in the palm of the treated hand.
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Interventions
Louis Widmer Remederm® Face Cream Without Perfume 50 ml is a skin care product that contains vitamin E as an active ingredient. Before applying Remederm®, the following are advised: On dry clean skin thoroughly before applying Remederm®, apply a layer of cream cutaneous to the hand palm, twice a day: morning and evening, massage cream into skin until absorbed. This procedure is applied by the patient treated with Vaseline or Remederm®.
Nodule evolution will be measured with ultrasound.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06321991