Patient Insight With Collagenase Treatment for Dupuytren: A Prospective Study

J Hand Surg Am. 2022 Jun 16;S0363-5023(22)00260-X. doi: 10.1016/j.jhsa.2022.04.013. Online ahead of print.

Abstract

Purpose: There appears to be controversy regarding differing patient and physician perceptions of adverse effects (AEs) in the treatment of Dupuytren disease with collagenase clostridium histolyticum (CCH). The aim of this study was to compare the number, type, and severity of AEs perceived and reported by patients and by their physician METHODS: To assess AEs following CCH injection in a standardized way, patients were given a list of predefined complications and asked to rate their severity on a 4-point Likert scale ranging from 1 (serious) to 4 (insignificant).

Results: Eighty-five patients were included. Patients reported fewer AEs than their physician (mean, 1.48 vs 2.18). There was no agreement between physician- and patient-reported AEs except for skin lacerations, which showed fair agreement (κ = 0.257).

Conclusions: Patients and physicians differ in their evaluation of AEs due to CCH treatment in Dupuytren disease. A fair level of agreement was observed for skin lacerations.

Clinical relevance: Greater consensus is needed when defining AEs associated with CCH in the treatment of Dupuytren disease.

Keywords: Collagenase; Dupuytren′s disease; Kappa; complications; patient perception.