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Millions afflicted by a disease that leaves them with an almost useless "claw hand" could soon benefit from a drug that stops the disease before it can cause harm.
It also means many could avoid risky surgeries - which can damage delicate nerves and tear tendons in the hand.
The drug adalimumab is a powerful anti-inflammatory drug that is already widely used to treat rheumatoid arthritis and is given as an injection every three months.
British medics who tested its use on hand deformities said they were amazed at the drug's effectiveness. Professor Jagdeep Nanchahal, a hand surgery expert 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 Brits. It causes lumps of scar tissue to develop on the palms of the hands.
Millions afflicted by a disease that leaves them with an almost useless "claw hand" could soon benefit from a drug that stops the disease before it can cause harm. The exact cause is a mystery, but 80% of cases are considered hereditary and it usually affects people over 50. Conservative Prime Minister Baroness Thatcher famously suffered from it in her right hand
Claw hand, properly called Dupuytren's disease, affects around five million Brits. 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, so-called cords, that pull the fingers of the hand inwards. If left untreated, the condition can make everyday tasks such as writing, typing or preparing food extremely difficult.
The exact cause is a mystery, but 80 percent of cases are considered hereditary and it usually affects people over 50. Conservative Prime Minister Baroness Thatcher is known to have suffered from it, as did actor Bill Nighy.
Non-surgical interventions – including steroid injections, radiation therapy and shock wave therapy – have been tried, but none have proven effective in stopping the condition in its tracks.
Therefore, the only real option is surgery, which involves cutting open the hand to remove the diseased tissue.
In the UK this is only offered in advanced stages of the disease when the fingers are completely bent inwards.
Now specialists hope that adalimumab could stop the condition in its earlier stages.
It works by binding to and neutralizing inflammatory molecules called Tumor Necrosis Facto, or TNF, produced by cells in the palms of the hands. Inflammation is thought to trigger the buildup of scar tissue that forms the cords.
Actor Bill Nighy (above) is among those affected. British doctors testing the use of adalimumab for hand deformities said they were amazed by the drug's effectiveness. The drug is a powerful anti-inflammatory drug that is already widely used to treat rheumatoid arthritis and is given as an injection every three months
In the Oxford study, 140 patients with early-stage Dupuytren's disease were divided into two groups. One received a 40mg injection of adalimumab - which costs around £350 per syringe - every three months for a year, injected directly into the lumps on patients' hands. The other group received a dummy drug.
The researchers found that the nodules shrank significantly in the adalimumab group, but not in the placebo group. They also become much softer. Nine months after completing treatment, the benefits were still evident in most patients, reducing the likelihood of surgery.
Professor Nanchahal said: "Adalimumab has been used safely to treat millions of people with arthritis around the world - we had no adverse events in our study, 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. In 2017, she first noticed a bump on her left palm. A cord soon began to form - which she describes as a hard rope from the heel of her hand to the base of her fingers.
Her primary care physician referred her to a hand specialist who diagnosed Dupuytren's disease. At that time, the bend in her finger was only five to ten degrees - an operation is usually only offered when it is at least 30 degrees.
Andrea said: "I was told there was nothing I could do but wait for the operation and even then it could come back anyway. I know Dupuytren's can make everyday activities like exercising or applying make-up almost impossible. I didn't want to end up like that."
Andrea was enrolled in the adalimumab trial in 2019 and received the injections into a lump on her left hand. She still doesn't know whether she got the drug or the placebo, but the bumps on her left hand have not progressed in the three years since and she has almost full mobility.
Meanwhile, the cord on her untreated right hand has become more and more prominent.
“I am very happy that I came to the trial,” she said. “If you can’t cure the condition, being able to prevent it from getting worse is fantastic.
“If I am offered surgery on my right hand in the future, I will take it, but I would much rather have adalimumab injections.”
Weird Science: Identical twins with very different IQs
A pair of identical twins separated as infants were found to have significantly different IQs as adults.
Born in South Korea in 1974, one got lost in a market at the age of 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 who were separated as infants were found to have significantly different IQs as adults. (file image)
An IQ test showed that the twin sister, who was raised in the United States, scored 16 points lower than her Korean sister, contradicting studies that say the differences between twins are never more than seven points.
The magazine Personality and Individual Differences said the US sister growing up suffered three concussions which may have affected her cognitive abilities.
Your amazing body
There are few things more frustrating than the wet pop of a failed sneeze.
It happens because the reflex has two main phases. The first is the sensitive phase, when something irritates the mucous membranes of the nose and throat.
This stimulates nerve impulses that initiate the second phase, which includes a sharp inhalation, closing of the eyes, and finally sneezing.
Absence of sneezing occurs when irritants in the nasal lining decrease or the body becomes distracted so that the electrical signal that triggers the sneeze is lost in transmission.