On the course, risk factors, and treatment outcomes of Dupuytren’s disease
| PhD ceremony: | Ms B.A. (Bente) van den Berge |
| When: | August 30, 2023 |
| Start: | 14:30 |
| Supervisor: | prof. dr. P.M.N. (Paul) Werker |
| Co-supervisor: | dr. D.C. (Dieuwke) Broekstra |
| Where: | Academy building RUG |
| Faculty: | Medical Sciences / UMCG |
On the course, risk factors, and treatment outcomes of Dupuytren’s disease
This thesis investigated the disease progression and risk factors of Dupuytren's disease. The results show that a minority of the patients studied show disease progression after a seven-year period. Familial burden and having related diseases increase the risk of progression. Hand injury is a risk factor for the development of the disease.
Increased risk Dupuytren hand workers
We investigated the relationship between handwork exposure and Dupuytren's disease in a large-scale cohort study, which showed an increased risk of Dupuytren's disease in handworkers.
Outcomes three most common treatments
We also examined the outcomes of the three most common treatments for Dupuytren's disease: percutaneous needle fasciotomy, collagenase clostridium histolyticum injection and limited fasciectomy. These treatments showed similar corrections of contractures (forced muscle position).
Injections with collagenase clostridium histolyticum resulted in more mild complications than the other treatments. Limited fasciectomy had the lowest recurrence risk up to five years after treatment. The long-term risk of re-treatment was found to be higher after percutaneous needle fasciotomy than after limited fasciectomy. Nevertheless, percutaneous needle fasciotomy seemed suitable for repeated application, as there was consistent effectiveness of corrections after multiple consecutive treatments.
Remote patient monitoring
Finally, we investigated the predictive value of hand function questionnaires on future treatment for Dupuytren's disease. Hand function scores measured about a year before treatment were found to be predictive of treatment. This shows we could use questionnaires in the future to monitor patients remotely.
These findings could help optimise treatment of the disease and improve (individualised) patient care.