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Collagenase Clostridium histolyticum in Dupuytren’s contracture: a guide to its use in the EU

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Abstract

Collagenase Clostridium histolyticum (CCH; Xiapex®) is an injectable enzymatic collagenase approved for the treatment of Dupuytren’s contracture (DC). In two double-blind studies, up to three injections (mean of 1.5) of CCH per cord at monthly intervals were significantly more effective than placebo in reducing contractures, achieving clinical success in 64 % of treated joints affected by DC. CCH is generally well tolerated, with most adverse effects being local, transient injection-site reactions, such as oedema, pain and bruising. There is some evidence suggesting that CCH is associated with fewer major complications than open fasciectomy among selected patients. Estimated costs associated with CCH are generally lower than those associated with fasciectomy, but cost-effectiveness based on accepted willingness-to-pay thresholds is dependent on injection price.

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Acknowledgments

The review was reviewed by: F. Araujo, Pablo de Olavide University, Seville, Spain; S. Saluja, Saran Ashram Hospital, Dayalbagh, Agra, India; R. B. Shah, GMERS Medical College and Hospital, Gandhinagar, Gujarat, India; C. Zhou, Erasmus University Medical Centre, Rotterdam, The Netherlands. During the peer review process, the manufacturer of Xiapex® in Spain was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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  1. Springer, Private Bag 65901, Mairangi Bay, 0754, Auckland, New Zealand

    Kate McKeage & Katherine Ann Lyseng-Williamson

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  1. Kate McKeage
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  2. Katherine Ann Lyseng-Williamson
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Correspondence to Katherine Ann Lyseng-Williamson.

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The preparation of this review was not supported by any external funding.

Conflicts of interest

K. McKeage and K. A. Lyseng-Williamson are salaried employees of Adis/Springer, are responsible for the article content and declare no conflicts of interest.

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McKeage, K., Lyseng-Williamson, K.A. Collagenase Clostridium histolyticum in Dupuytren’s contracture: a guide to its use in the EU. Drugs Ther Perspect 32, 131–137 (2016). https://doi.org/10.1007/s40267-016-0291-8

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