Millions struck by a disease that leaves them with an almost useless ‘claw hand’ could soon benefit from a drug that halts the condition before it can do any damage.
It also means many could avoid risky surgery – which can damage sensitive nerves and tear tendons in the hand.
The drug, adalimumab, is a powerful anti-inflammatory already widely used to treat rheumatoid arthritis and given as an injection every three months.
British medics trialling its use for hand deformity say they were amazed at the drug’s effectiveness. Professor Jagdeep Nanchahal, an expert in hand surgery at Oxford University‘s Kennedy Institute, where adalimumab is being tested, said: ‘My eyes popped out of my head when I saw the results. I thought, this is incredible.’
Claw hand, properly called Dupuytren’s disease, affects around five million Britons. It causes lumps of scar tissue to develop on the palms of the hands.
Millions struck by a disease that leaves them with an almost useless ‘claw hand’ could soon benefit from a drug that halts the condition before it can do any damage. The exact cause is a mystery but 80% of cases are thought to be hereditary, and it usually affects those over 50. Famously, Conservative Prime Minister Baroness Thatcher suffered from it in her right hand
Claw hand, properly called Dupuytren’s disease, affects around five million Britons. It causes lumps of scar tissue to develop on the palms of the hands. (Above, Lady Thatcher in 1990)
Over time, these form thick bands, called cords, which pull the fingers of the hand inwards. Left untreated, the condition can make day-to-day tasks like writing, typing or preparing food extremely difficult.
The exact cause is a mystery but 80 per cent of cases are thought to be hereditary, and it usually affects those over 50. Famously, Conservative Prime Minister Baroness Thatcher suffered from it, as does actor Bill Nighy.
Non-surgical interventions – including steroid injection, radiotherapy and shockwave therapy – have been trialled, but none have proved effective at halting the condition in its tracks.
As a result, the only real option is surgery, where the hand is cut open to strip away the diseased tissue.
In the UK, this is only offered in the advanced stages of the disease when the fingers are totally bent inward.
Now specialists hope adalimumab could halt the condition in the earlier stages.
It works by binding to and neutralising inflammatory molecules, called Tumour Necrosis Facto, or TNF – produced by cells in the palms of the hands. It’s thought inflammation is what triggers the build-up of scar tissue that forms the cords.
Among those affected by the condition is actor Bill Nighy (above). British medics trialling adalimumab use for hand deformity say they were amazed at the drug’s effectiveness. The drug is a powerful anti-inflammatory already widely used to treat rheumatoid arthritis and given as an injection every three months
On the Oxford trial, 140 patients with early-stage Dupuytren’s were split into two groups. One received a 40 mg injection of adalimumab – which costs around £350 per jab – every three months for a year, injected directly into the lumps on patients’ hands. The other group received a dummy drug.
Researchers found nodules shrunk significantly in the adalimumab group but not the placebo group. They also become much softer. Nine months after the treatment finished, the benefits were still evident in most patients, reducing the likelihood of surgery.
Professor Nanchahal said: ‘Adalimumab has been safely used to treat millions of people with arthritis around the world – we had no adverse events in our trial, so we know the drug is safe to use.’
Andrea Svalay, 60, from Highbury, north London took part in the adalimumab trial after suffering from Dupuytren’s disease for a year and a half. She first noticed a lump on the palm of her left hand in 2017. Soon, a cord began to form – which she describes as a hard rope from the heel of her palm to the base of her finger.
Her GP referred her to a hand specialist who diagnosed Dupuytren’s disease. The bend in her finger was only five to ten degrees at the time– surgery is usually only offered once it reaches at least 30 degrees.
Andrea said: ‘I was told there was nothing I could do other than wait for surgery, and even then it might come back anyway. I know Dupuytren’s can make day-to-day activities like exercising or putting on make-up near impossible. I didn’t want to end up like that.’
Andrea was enrolled on the adalimumab trial in 2019 and had the injections into a lump on her left hand. She still does not know if she had the drug or the placebo but the lumps on her left hand have not progressed in the three years since and she has almost complete range of movement in it.
Meanwhile, the cord on her untreated right hand has grown progressively more prominent.
‘I’m very glad I got on the trial,’ she said. ‘If you can’t cure the condition, it’s fantastic to be able to prevent it from getting worse.
‘If I’m offered surgery on my right hand in future, I’ll take it, but I’d much rather have injections of adalimumab.’
Weird science: Identical twins with very different IQs
A pair of identical twins separated as infants were found to have substantially different IQs as adults.
Born in South Korea in 1974, one got lost at a market aged two and was later adopted by a US couple. They were reunited in 2018 when the US twin submitted DNA to a South Korean database.
A pair of identical South Korean twins separated as infants were found to have substantially different IQs as adults. (File image)
An IQ test showed the twin raised in the US scored 16 points lower than her Korean sibling, contradicting studies that say differences among twins are never more than seven points.
The journal Personality and Individual Differences said the US sister raised had suffered three concussions which may have influenced her cognitive ability.
Your amazing body
There are few things more frustrating than the damp squib of a failed sneeze.
It happens because there are two main phases to the reflex. The first is the sensitive phase, where something irritates the membranes of the nose and throat.
This stimulates nerve impulses that start the second phase, involving a sharp intake of breath, eyes closing and the eventual sneeze.
Failed sneezes occur when irritants in the nasal lining reduce or the body becomes distracted, so the electrical signal that triggers the sneeze is lost in transit.