ACTA1 and Dupuytren Contracture: Taken together with our findings that anti-TNF down-regulates the myofibroblast phenotype (α-SMA and collagen type 1 expression and contractility) in vitro,15,16 and our earlier phase 2a data showing that 40 mg of adalimumab in 0· 4 mL reduces the expression of α-SMA and procollagen type 1 proteins,18 the data from this phase 2b trial suggest that intranodular injections of adalimumab might reduce progression of early-stage Dupuytren’s disease.