NICE has issued guidance on the use of collagenase in the NHS, it is now allowed for moderate Dupuytren’s disease with a few provisions. The full recommendation (final appraisal determination document) is available for download from our download page . The Scottish Medical Consortium has accepted restricted use of Xiapex in the NHS; the All Wales Medicines Strategy Group has approved the use of Xiapex for treatment within the NHS Wales. The final decision however is with the local CCG who decide at what stage what treatment will be accepted on the NHS.
These eye drops and ointments contain a combination of a steroid and one or more types of antibiotic for treatment of infection and inflammation of the eye. The steroid reduces inflammation while the antibiotic treats or prevents infection which may be the cause of the infection. Examples of steroids that are used in these eye drops are hydrocortisone, loteprednol, prednisolone, and dexamethasone . Examples of antibiotics used in these formulations include tobramycin, neomycin, bacitracin, polymixin B, and gentamycin. These antibiotics have different mechanisms of action and two or three may be combined in one formulation.
Dupuytren's disease (Dupuytren disease), also called Dupuytren's contracture or simply Dupuytrens, is a benign thickening of the palm's or finger's connective tissue. Dupuytren disease is the most crippling hand problem and affecting many people, especially when they get older. Dupuytren disease typically starts with a tiny nodule in the palm. Eventually cords develop and in progressed stages the affected fingers cannot be fully stretched anymore, thus resulting in what is called "Dupuytren's contracture". Note that below picture is showing a very progressed stage of Dupuytren's contracture. Most patients have much less severe symptoms of Dupuytren disease and many people with initial symptoms of Dupuytren's will never need any treatment at all. For those who need treatment, a variety of treatments is available, depending on the stage of disease and on the preference of the patients. All these treatments options of Dupuytren disease are explained on this website, including their potential side effects.