Researchers at the Kennedy Institute and Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, working with clinicians at NHS Lothian, have found that injection of the anti-TNF drug adalimumab into Dupuytren’s disease nodules results in the reduction of the cell characteristics responsible for progression of Dupuytren’s disease.
Based on their laboratory data that tumour necrosis factor (TNF) drives the development of myofibroblasts, the cell type that causes Dupuytren’s disease, the research team explored the effect of an anti-TNF drug injected directly into the Dupuytren’s nodule tissue. The results so far are very promising.
“Our data have shown that a concentrated formulation of adalimumab injected directly into the diseased tissue may be effective in targeting the cells responsible for Dupuytren’s disease,” said Jagdeep Nanchahal, MD, PhD, University of Oxford Professor of Hand, Plastic and Reconstructive Surgery, who led the study.
“This brings new hope to people who suffer from this disabling condition, who currently have to wait for their situation to be deteriorate, watching their hand lose function until it is bad enough for surgery. And then there’s the lengthy recovery ahead, a less than ideal situation to find yourself in.”
This 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 EBioMedicine, published by The Lancet.
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 anti-TNF drug adalimumab (Humira) is currently licensed in the EU for the treatment of a number of conditions including rheumatoid arthritis, Crohn’s disease and ulcerative colitis and overall has an excellent safety profile.
“We are delighted to have received further funding from the Wellcome Trust and Department of Health to test whether adalimumab will work for patients with early stage Dupuytren’s disease,” said Professor Sir Marc Feldmann, co-author and former director of the Kennedy Institute. In conjunction with Professor Sir Ravinder Maini, Sir Marc identified TNF as a therapeutic target in patients with rheumatoid arthritis.
“The Kennedy Institute has a long history of successfully translating laboratory findings to the clinic'” said Professor Fiona Powrie, Director of the Institute. “This type of work requires close collaboration between laboratory scientists, clinical trialists and clinician scientists over many years”.
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 Latest on: Dupuytren’s disease
via Google News
The Latest on: Dupuytren’s disease
- 'Treatment for rare skin condition affecting fingers lies in the palm of your hand'on October 4, 2021 at 3:33 pm
and the penis (Peyronie’s disease). Dupuytren’s disease is progressive and for some sufferers it can be severely debilitating, with patients experiencing considerable limitations at work and ...
- Advances in Minimally Invasive Treatment of Hand Disorderson September 29, 2021 at 5:00 pm
New studies regarding less invasive treatment of Dupuytren’s disease and cubital tunnel syndrome (ulnar nerve entrapment at the elbow) have been reported in the past two years and have begun to ...
- Bill Nighy health: What is the condition that affects the star's hands?on September 29, 2021 at 10:30 am
The star also suffers from a genetic condition called Dupuytren's Contracture ... in the overall management of this very frustrating disease. The injection allows more patients to return to ...
- 20 diseases with unknown causeson September 28, 2021 at 11:59 am
Despite its genetic origin and its discovery in the 19th century by French surgeon Guillaume Dupuytren, the disease still has no known cause. Ossification of the posterior longitudinal ligament As ...
- Kevin O’Hara: Be careful what you wish foron September 20, 2021 at 12:41 pm
The no-nonsense surgeon readily diagnosed my misshapen finger as Dupuytren’s contracture, aka Viking’s disease. He further explained that the only option to straighten my appendage was to undergo ...
- Researchers develop AI platform to boost vaccine developmenton September 16, 2021 at 2:50 pm
Infectious diseases kill millions of people annually worldwide. However, vaccination has proven to be an effective measure to control infectious diseases, and the rapid emergence of COVID-19 has shown ...
- Adult Myopia Market to Project High at a 10.46% CAGR During the Study Period [2018-2030], States DelveInsighton September 15, 2021 at 1:27 pm
DelveInsight's Adult Myopia - Epidemiology Forecast 2030 report delivers an in-depth understanding of the disease, historical, and forecasted epidemiology of Adult Myopia in the 7MM. Transdermal ...
via Bing News