Researchers at the Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), led by Professor Jagdeep Nanchahal have demonstrated the efficacy of the anti-TNF drug adalimumab for patients with early stage Dupuytren's disease.
"This phase 2b trial represents the clinical translation of our laboratory findings, where we identified TNF as a potential therapeutic target followed by a phase 2a dose ranging trial which showed that the highly concentrated formulation injected directly into the diseased tissues was effective in downregulating myofibroblasts, the cells responsible for fibrosis," said Jagdeep Nanchahal, Oxford Professor of Hand, Plastic and Reconstructive Surgery. "We also found the treatment to be completely safe and there were no related serious adverse events."
Dupuytren's disease is a common condition of the hand that affects about 5% of the UK population and tends to run in families. It causes the fingers to curl irreversibly into the palm and can be extremely disabling. There is currently no treatment for early disease and typically people have to wait until the condition deteriorates when surgery can be performed.
The trial recruited 140 participants with early-stage Dupuytren's disease who were randomised to receive 4 injections at 3 monthly intervals of either adalimumab (40mg adalimumab in 0.4ml) or saline. The primary outcome was nodule hardness measured at 12 months, and patients were followed up for a total of 18 months.