Can an existing drug slow Dupuytren's disease?

The short version

1. A drug would need to be given early. The cells that drive the disease are packed into the early lumps (nodules). By the time a finger is stuck bent, most of them have gone. How the disease works
2. Very few drugs have been tested properly. Only adalimumab has been tested on its own in a randomised trial. Six others were tested only as add-ons to surgery or an injection. The rest are lab studies or single case reports. What's been tried
3. Trials are expensive, mostly because of how they measure success. Measuring how hard a nodule is needs about 136–160 patients. Measuring hand function needs about 708–826. Nobody knows how often untreated early disease gets worse, and that number is needed to plan a prevention trial. From idea to prescription
4. The best-tested drugs and the anti-scarring drugs are different drugs. No candidate does well on both counts. Pirfenidone and metformin are the two I'd look at first. The drug candidates
5. Better measurement would help everything else. A cheap, sensitive way to measure hand function at home could shrink trials, cut follow-up costs and supply that missing progression rate. Measuring hand function

How to read this site

The pages run in order, from what the disease is, through what's been tried, to where I think research should go. Each one starts with a short summary of what it covers. Underlined terms have a plain-English explanation if you hover over or tap them, and every PMID label opens the paper it refers to.