Dupuytren’s disease is a common condition of the hand that affects 4% of the UK population and causes the fingers to curl irreversibly into the palm. There is currently no NICE approved treatment for early disease and typically people are told to return to their GP once their fingers become so bent that their hand function is impaired.
The randomised trial (phase 2a) recruited 28 patients with Dupuytren’s disease who were scheduled to have surgery in Edinburgh to remove diseased tissue in their hand. Two weeks prior to surgery they received a single injection of varying doses of the anti-TNF drug, or placebo. The tissue removed during surgery, which is usually discarded, was then analysed in the laboratory. The team found that adalimumab (at a dose of 40mg formulated in 0.4ml) reduces expression of the fibrotic markers, -smooth muscle actin (-SMA) and type I procollagen, at 2 weeks post injection, suggesting this drug could be used to stop the growth of disease causing myofibroblast cells. They also found the drug to be safe and well tolerated.
The findings are published on line in the journal EBioMedicin
The researchers are continuing to investigate the use of this drug to treat Dupuytren’s disease in a phase 2b trial called the RIDD trial, which is currently running in Oxford and Edinburgh.
The research was funded by the Health Innovation Challenge Fund which is a collaboration between the Wellcome Trust and the Department of Health. Funding for the drug was provided by 180 Therapeutics.
e, published by The Lancet.