Dupuytren’s disease is a very common condition, affecting 4% of the general UK population. Following the initial appearance of nodules the disease progresses, causing the fingers to curl towards the palm and resulting in significant impairment of hand function. Currently there is no approved treatment for early disease, and patients must wait until the finger has contracted significantly before a surgical procedure is offered. Unfortunately, the condition often returns. Prof Nanchahal’s lab have extensively researched the molecular basis of Dupuytren’s disease by studying tissue that is normally discarded at the time of surgery. Our lab data show that Dupuytren’s disease is a localised inflammatory condition and the cells that produce the excess tissue and cause the contractures are dependent on the cytokine TNF. Drugs which inhibit TNF (called anti-TNF drugs) are already used widely to treat inflammatory arthritis and inflammatory bowel conditions.
The first part of the study will test different doses of anti-TNF injected once into the nodules of Dupuytren’s patients due to have hand surgery. We will study the excised tissue in our lab to assess which dose is most effective. For this part of the trial we will be recruiting up to 40 patients with advanced Dupuytren’s contracture. For the second part of the study we will recruit approximately 140 people at the early stages of Dupuytren’s disease. Participants will receive injections of anti-TNF or placebo every 3 months for a year. We will monitor disease progression and hand function over an 18 month period to determine whether these injections can help patients and avoid the need for surgery.