Dupuytren's Interventions: Surgery vs. Collagenase (DISC) Trial
Joe Dias, Professor of Hand and Orthopaedic Surgery in the Department of Health Sciences at the University of Leicester and his colleagues at Leicester’s Hospitals have been awarded a National Institute of Health Research (NIHR) Health Technology Assessment (HTA) grant of just under £2million for the Dupuytren’s Interventions Surgery vs. Collagenase (DISC) Trial.
Following a temporary pause to all non covid research in the UK due to the COVID-19 pandemic, the DISC Trial recommenced recruitment in stages from July 2020. Amendments to the study protocol were approved in August 2020 to ensure procedures are in place to limit any potential risks to participants due to COVID-19.
The importance of this research remains, Dupuytren’s Contracture is the fourth most common problem affecting the hand in the UK. The disorder, occurring mostly in adult men, is caused by fibrous tissue forcing the finger to bend down into the palm of the hand. Although it is rarely painful, patients cannot straighten the finger and this increasingly interferes with hand function.
The most common and accepted treatment method is surgery to straighten the bent finger by removing the fibrous tissue. Each year, surgery is performed on around 17,000 patients in England which costs the NHS over £60 million.
An alternative method to surgery is a newly introduced Collagenase injection (CCH) which softens the fibrous tissue. Administered in clinic, with a follow up clinic appointment a few days later, the finger is manipulated in an attempt to straighten it.
The National Institute of Health and Clinical Excellence (NICE) has recently (July 2017) updated their guidance on the use of collagenase (Technology Assessment 459), and acknowledge that the DISC trial and the findings it will generate will be crucial in determining if the injection is no worse than surgery and whether the effects are sustained in the long-term.
Patients who are interested in participating in the DISC Trial will be reviewed by their consultant. If eligible and happy to take part, they will be randomly allocated to receive the injection or surgery. There will be an equal chance of getting either treatment. After treatment, patients will be asked to complete questionnaires over a two-year period to assess how they feel about their hand and the bend in the finger will be measured at regular intervals.
Further details regarding the study are available at:
If you require any further information about this study, please do not hesitate to contact the Trial Management Team for further information. We hope that we can work with you to provide patients with information on this study and hopefully facilitate their involvement in the DISC trial.
(Information updated November 2020)