Needle release optimal treatment for Viking disease

June 13, 2018, University of Gothenburg
Dupuytren contracture. Credit: University of Gothenburg

The various treatments for Viking disease are coming under closer scrutiny. Research shows that crooked fingers can be straightened just as well with needle release as with the substantially more expensive commonly used drug.

"Whether or not the general Swedish healthcare system should subsidize drug treatment should definitely be called into question," says Dr. Joakim Strömberg, an orthopaedic and hand surgeon at Sahlgrenska University Hospital who holds a Ph.D. from Sahlgrenska Academy, Sweden.

Dupuytren's contracture, which has been referred to as Viking disease, is a common ailment that affects about 10 percent of men and 2 percent of women in the Nordic countries. The disease is most common among individuals older than 60.

In this condition, a cord consisting of pathological connective tissue forms on the palmar side of the finger, which over time can prevent the finger from being straightened. The pinky and ring fingers are most commonly affected, often in both hands. In addition to age, the disease can also be linked to factors such as heredity and diabetes.

Large price difference

For his thesis, Joakim Strömberg studied 156 patients who were treated either with Xiapex, an injectable fluid that dissolves the collagen to break down the cord, or by fasciotomy, a minimally invasive procedure carried out under local anesthesia in which a needle is used to disrupt the cord.

Needle release optimal treatment for Viking disease
Needle fasciotomy. Credit: University of Gothenburg

Follow-up at six months, one year and two years showed no significant differences between the two groups, with the exception that those who received Xiapex had more pain at the one-year recheck. The price of a dose of Xiapex is about SEK 6,500, while the material for a needle fasciotomy costs SEK 150.

It should also be mentioned that when Xiapex became available in the early 2010s, it was half as expensive as the standard open surgery treatment of that time. In addition, a patient could be treated multiple times with Xiapex or needle fasciotomy, which would have been substantially more difficult using open surgery.

Fewer problems

The often recurs and needs to be treated again, which increases the importance of interventions that can be repeated. This is yet another reason to use the more modern needle release procedure, according to Joakim Strömberg, who is in clinical practice in Region Västra Götaland, where the use of Xiapex is not reimbursed.

"In my opinion, there has been excessive faith in the ability of this drug to break down the cord better than surgery, while in many places alternative solutions have been forgotten or never even considered. The needle release is not at all as troublesome for patients. This extremely simple method does not produce as much pain afterwards, nor does it require any specific rehabilitation," says Joakim Strömberg.

Explore further: Collagenase for Dupuytren's contracture: Added benefit not proven

Related Stories

Collagenase for Dupuytren's contracture: Added benefit not proven

July 12, 2012
Collagenase extracted from Clostridium histolyticum (trade name: Xiapex) was approved in the beginning of 2011 for the treatment of people with Dupuytren's contracture. In an early benefit assessment pursuant to the "Act ...

Study looks at needles in treatment for shoulder pain

June 14, 2017
According to a new study published online in the journal Radiology, the type of procedure used to treat shoulder calcifications should be tailored to the type of calcification. The results of the study will help interventional ...

Internet of Things smart needle probes the brain during surgery

January 20, 2017
A "smart" needle with an embedded camera is helping doctors perform safer brain surgery.

Increase in prostate needle biopsy-linked infection in N.Y.

April 18, 2017
(HealthDay)—Infectious complications after prostate needle biopsy increased from 2011 to 2014 across New York State, according to a study published in the April issue of The Journal of Urology.

First endoscopic stricturotomy with needle knife study for intestinal strictures in IBD

April 28, 2017
Cleveland Clinic doctors have published the first study illustrating the safety and efficacy of endoscopic needle knife therapy for intestinal strictures in patients with inflammatory bowel disorder (IBD).

Recommended for you

Researchers cure drug-resistant infections without antibiotics

October 17, 2018
Biochemists, microbiologists, drug discovery experts and infectious disease doctors have teamed up in a new study that shows antibiotics are not always necessary to cure sepsis in mice. Instead of killing causative bacteria ...

How drug resistant TB evolved and spread globally

October 17, 2018
The most common form of Mycobacterium tuberculosis (TB) originated in Europe and spread to Asia, Africa and the Americas with European explorers and colonialists, reveals a new study led by UCL and the Norwegian Institute ...

Infectious disease consultation significantly reduces mortality of patients with bloodstream yeast infections

October 17, 2018
In a retrospective cohort study conducted at the University of Alabama at Birmingham Division of Infectious Diseases, patients with candidemia—a yeast infection in the bloodstream—had more positive outcomes as they relate ...

Marker may help target treatments for Crohn's patients

October 16, 2018
Crohn's disease (CD), a chronic inflammatory condition of the intestinal tract, has emerged as a global disease, with rates steadily increasing over the last 50 years. Experts have long suspected that CD likely represents ...

Study traces hospital-acquired bloodstream infections to patients' own bodies

October 15, 2018
The most common source of a bloodstream infection acquired during a hospital stay is not a nurse's or doctor's dirty hands, or another patient's sneeze or visitor's cough, but the patient's own gut, Stanford University School ...

Polio: Environmental monitoring will be key as world reaches global eradication

October 15, 2018
Robust environmental monitoring should be used as the world approaches global eradication of polio, say University of Michigan researchers who recently studied the epidemiology of the 2013 silent polio outbreak in Rahat, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.