From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Multiple palmar fibromatosis, also known as Dupuytren's contracture, is a condition that is best managed with percutaneous needle fasciotomy (PNF) or collagenase injections (Xiaflex), with PNF showing some evidence of superior clinical outcomes and a lower minor complication rate compared to collagenase injections, as reported in a systematic review of comparative studies 1.
Overview of the Condition
Multiple palmar fibromatosis is a benign proliferation of fibroblasts and myofibroblasts that can lead to nodules and contracture in the palm of the hand, causing fingers to bend inward toward the palm. The condition is more common in men over 50, people of Northern European descent, and those with certain risk factors including diabetes, smoking, alcohol consumption, and family history.
Treatment Options
Treatment options for multiple palmar fibromatosis depend on the severity of the condition. For mild cases, observation may be sufficient. As the condition progresses, treatment may include:
- Needle aponeurotomy (using a needle to break up the cords)
- Collagenase injections (Xiaflex) to dissolve the cords
- Surgery to remove the affected tissue
- Physical therapy to maintain hand function after any intervention
Recent Evidence
A recent systematic review of comparative studies found that PNF may have superior clinical outcomes and a lower minor complication rate compared to collagenase injections 1. Another study found that electron radiation therapy can be an effective treatment option for early-stage palmar and plantar fibromatosis, with a high rate of patient satisfaction and minimal toxicity 2.
Recommendations
Based on the most recent and highest quality evidence, PNF is recommended as a treatment option for multiple palmar fibromatosis, due to its potential for superior clinical outcomes and lower minor complication rate compared to collagenase injections 1. Regular monitoring is important, as the disease often affects both hands and may recur after treatment. If you notice nodules or cords in your palm or difficulty laying your hand flat, consult a hand specialist for evaluation and treatment recommendations.