Amelioration of Dupuytren's disease

Abstract

The cords of Dupuytren's disease are injected with collagenase, the hand is immediately immobilized and maintained immobile for several hours. The cord becomes relaxed or ruptured, relieving the hand contracture of the disease.

I claim:  
     
       1. A method of treating an individual suffering from Dupuytren's disease which comprises injecting collagenase into a fibrous Dupuytren's cord in a hand of the individual suffering from the disease, immobilizing the hand immediately after injection, and maintaining the hand immobile for several hours, the amount and concentration of the collagenase being effective to relax or rupture the cord whereby the finger flexure caused by the cord is ameliorated. 
     
     
       2. A method according to  claim 1  wherein a total amount of collagenase of at least 8,000 ABC units is injected in a pharmaceutically acceptable carrier in a concentration of at least about 30,000 ABC units per ml. 
     
     
       3. A method according to  claim 2  wherein the total amount of collagenase is at least 10,000 ABC units and the concentration is at least about 40,000 ABC units per ml. 
     
     
       4. A method according to  claim 1  wherein the collagenase is injected in a pharmaceutically acceptable carrier and the total volume of liquid injected does not exceed about 0.5 ml. 
     
     
       5. A method according to  claim 4  wherein the total volume of liquid injected is in the range of 0.25 to 0.1 ml. 
     
     
       6. A method according to  claim 1  wherein the injection is effected at multiple points in close proximity. 
     
     
       7. A method according to  claim 6  wherein the injections are made at least three points in close proximity. 
     
     
       8. A method according to  claim 1  wherein the individual is in the residual stage of Dupuytren's disease. 
     
     
       9. A method according to  claim 1  wherein the hand is maintained immobile for a period of from 4 to 10 hours. 
     
     
       10. A method according to  claim 1  wherein the injections are made at or near the metacarpophalangeal joint and/or the proximal interphalangeal joint. 
     
     
       11. A method according to  claim 1  wherein the depth of the Dupuytren's cord in the hand is quantified by ultrasound scanning prior to injecting the collagenase. 
     
     
       12. A method according to  claim 1  wherein the collagenase is in a pharmaceutically acceptable aqueous carrier. 
     
     
       13. A method of treating an individual suffering from Dupuytren's disease which comprises injecting into a fibrous Dupuytren's cord in a hand of the individual suffering from the disease an effective total amount of at least 8,000 ABC units of collagenase and wherein the collagenase is applied in a pharmaceutically acceptable carrier in a concentration of  20 , 000  to  50 , 000  ABC units collagenase per ml of carrier. 
     
     
       14. A method according to  claim 13  wherein the individual is in the residual stage of Dupuytren's disease. 
     
     
       15. A method according to  claim 13  wherein the total amount of collagenase is within a range of 8,000 to about 15,000 ABC units. 
     
     
       16. A method according to  claim 13  wherein the collagenase is applied in a pharmaceutically acceptable carrier in a concentration of about 15,000 to about 75,000 ABC units collagenase per ml of carrier. 
     
     
       17. A method according to  claim 13  wherein the collagenase is injected in a pharmaceutically acceptable carrier and the total volume of liquid injected does not exceed about 0.5 ml. 
     
     
       18. A method according to  claim 17  wherein the total volume of liquid injected is in the range of about 0.25 to 0.1 ml. 
     
     
       19. A method according to  claim 13  wherein the injections are made at acute angles to the cord. 
     
     
       20. A method according to  claim 13  wherein the collagenase is in a pharmaceutically acceptable aqueous carrier. 
     
     
       21. A method according to  claim 13  wherein the total amount of collagenase is at least  10 , 000  ABC units.  
     
     
       22. A method according to  claim 13  wherein the total amount of collagenase is at least  10 , 000  ABC units and the concentration is at least about  40 , 000  ABC units per ml.  
     
     
       23. A method of treating an individual suffering from Duputyren's disease which comprises injecting collagenase into a fibrous Duputyren's cord in a hand of the individual suffering from the disease wherein a total amount of collagenase of at least  5 , 000  ABC units is injected in a pharmaceutically acceptable carrier in a concentration of between  20 , 000  to  50 , 000  ABC units per ml and the total volume of liquid injected does not exceed about  0 . 5  ml.  
     
     
       24. A method according to  claim 23  wherein the total volume of liquid injected is in the range of  0 . 25  to  0 . 1  ml.  
     
     
       25. A method according to  claim 23  wherein the collagenase is administered at multiple sites of the cord.  
     
     
       26. A method according to  claim 25  wherein the injections are made at least three points in close proximity.  
     
     
       27. A method according to  claim 23  wherein the total amount of collagenase is at least  8 , 000  ABC units and the concentration is at least about  30 , 000  ABC units per ml.  
     
     
       28. A method according to  claim 23  wherein the hand is maintained immobile for a period of from  4  to  10  hours.  
     
     
       29. A method according to  claim 23  wherein the injections are made at or near the metacarpophalangeal joint and/or the proximal interphalangeal joint.  
     
     
       30. A method according to  claim 23  wherein the depth of the Dupuytren's cord in the hand is quantified by ultrasound scanning prior to injecting the collagenase.  
     
     
       31. A method according to  claim 23  wherein the injections are made at acute angles to the cord.  
     
     
       32. A method of treating an individual suffering from Duputyren's disease which comprises injecting an effective amount of collagenase into a fibrous Duputyren's cord in a hand of the individual suffering from the disease wherein the collagenase is applied in a pharmaceutically acceptable carrier in a concentration of  20 , 000  to  50 , 000  ABC units collagenase per ml of carrier and the total volume of liquid injected does not exceed about  0 . 5  ml.  
     
     
       33. A method according to  claim 32  wherein the total volume of liquid injected is in the range of about  0 . 25  to  0 . 1  ml.  
     
     
       34. A method according to  claim 32  wherein the injections are made at acute angles to the cord.  
     
     
       35. A method according to  claim 32  wherein the collagenase is administered at multiple sites of the cord.  
     
     
       36. A method according to  claim 35  wherein the injections are made at least three points in close proximity.  
     
     
       37. A method according to  claim 32  wherein the individual is in the residual stage of Dupuytren's disease.  
     
     
       38. A method according to  claim 32  wherein the total amount of collagenase is within a range of  8 , 000  to about  15 , 000  ABC units.  
     
     
       39. A method according to  claim 32  wherein the hand is maintained immobile for a period of from  4  to  10  hours.  
     
     
       40. A method according to  claim 32  wherein the injections are made at or near the metacarpophalangeal joint and/or the proximal interphalangeal joint.  
     
     
       41. A method according to  claim 32  wherein the depth of the Dupuytren's cord in the hand is quantified by ultrasound scanning prior to injecting the collagenase.  
     
     
       42. A method according to  claim 32  wherein the injections are made at acute angles to the cord.  
     
     
       43. A method according to  claim 32  wherein the individual is in the residual stage of Dupuytren's disease.