Chymopapain or Collagenase?
Chymopapain was first used in 1963 via intradiscal injection. Twenty years and over forty thousand patients later, “Intradiscal Therapy” was published in 1983. At this time collagenase, an alternative enzyme, was in it’s third stage of clinical trials.
The treatment of herniation of the nucleus pulposus represented a major breakthrough in the treatment of this common affliction. The purpose of this book was to summarize and correlate information on enzymes, chymopapain and collagenase in treatment of herniated discs so that orthopedists, neurosurgeons, neurologists, radiologists, anesthesiologists, auxiliary health personnel, and health care planners can make rational decisions as to their use.
After Dr. Brown reviewed literature on chemonucleolysis, conducted clinical trials with both chymopapain and collagenase, and observed the action of both enzymes in the laboratory, he asked himself which method he would choose if he had a disabling disc displacement?
Update of Enzyme Usage
Currently, several forms of chymopapain have been approved internationally by Federal Drug Administrations. Collagenase was never approved by the U.S. FDA for chemonucleolysis. However, it has been approved for Dupuytren’s Contacture of the hand and foot. Additionally, it has been approved for treatment of Peyronie’s Disease by the U.S. FDA. A recombinant form of chondroitinase ABC has been approved for chemonucleolysis in Japan.
Although this book is out-of-print, Dr. Brown is writing an updated edition of “Intradiscal Therapy” as treatment of disc disease has changed over the last almost forty years.