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接受胶原酶溶纤维蛋白治疗与行纤维切除术治疗掌腱膜挛缩症后的功能恢复。

Return-to-Function Following Treatment of Dupuytren Contracture With Collagenase Clostridium Histolyticum Versus Fasciectomy.

机构信息

IQVIA, Falls Church, VA, USA.

Endo Pharmaceuticals Inc., Malvern, PA, USA.

出版信息

Hand (N Y). 2022 May;17(3):491-498. doi: 10.1177/1558944720919923. Epub 2020 Jun 7.

Abstract

Dupuytren contracture (DC) treatment with collagenase clostridium histolyticum (CCH) has lower associated treatment costs than fasciectomy, but real-world, postprocedure return-to-function data are limited. This retrospective study used a US claims database and included adults treated for DC with CCH or fasciectomy (first treatment = index date), who had continuous health plan enrollment ≥360 days preindex and ≥90 days postindex (ie, 90-day follow-up). Analgesic use and physical therapy (PT) and occupational therapy (OT) visits during the follow-up were used as surrogate markers for return-to-function. Overall, 1654 and 2745 patients were included in the CCH and fasciectomy cohorts, respectively. A significantly lower percentage of patients in the CCH versus fasciectomy cohort used opioid analgesics (32.3% vs 82.7%; < .0001), used nonsteroidal anti-inflammatory drugs (8.6% vs 17.2%; < .0001), or had ≥1 DC-specific PT or OT visit during follow-up (PT, 38.9% vs 45.3% [ < .0001]; OT, 32.8% vs 38.0% [ = .0006]). The mean number of DC-specific PT and OT visits (PT, 2.5 vs 6.4 [ < .0001]; OT, 1.4 vs 1.9 [ < .0001]) per patient was significantly lower in the CCH versus fasciectomy cohort. This analysis using surrogate markers suggests that CCH treatment may allow earlier return-to-function than fasciectomy in adults treated for DC.

摘要

标题:成纤维细胞溶解胶原酶(CCH)治疗掌腱膜挛缩症的成本低于筋膜切除术,但真实世界的术后功能恢复数据有限。

这项回顾性研究使用了美国的索赔数据库,纳入了接受 CCH 或筋膜切除术治疗掌腱膜挛缩症的成年人(首次治疗=索引日期),他们在索引前 360 天和索引后 90 天(即 90 天随访)内持续参加健康计划。在随访期间使用镇痛药的使用情况以及物理治疗(PT)和职业治疗(OT)就诊作为功能恢复的替代指标。

总体而言,CCH 和筋膜切除术队列分别纳入了 1654 例和 2745 例患者。与筋膜切除术组相比,CCH 组使用阿片类镇痛药(32.3%比 82.7%;<0.0001)、非甾体抗炎药(8.6%比 17.2%;<0.0001)或在随访期间接受≥1 次掌腱膜挛缩症特定的 PT 或 OT 就诊的患者比例显著更低(PT,38.9%比 45.3%[<0.0001];OT,32.8%比 38.0%[=0.0006])。与筋膜切除术组相比,CCH 组每位患者接受掌腱膜挛缩症特定的 PT 和 OT 就诊的平均次数(PT,2.5 比 6.4[<0.0001];OT,1.4 比 1.9[<0.0001])显著更低。

使用替代指标的这项分析表明,在接受掌腱膜挛缩症治疗的成年人中,CCH 治疗可能比筋膜切除术更早恢复功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ec9/9112732/589c4a19e1a3/10.1177_1558944720919923-fig1.jpg

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