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Collagenase Clostridium Histolyticum: A Review in Peyronie’s Disease

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Abstract

Collagenase Clostridium Histolyticum (hereafter referred to as CCH) [Xiaflex®; Xiapex®] is a mixture of two Clostridium histolyticum collagenases [AUX-I (a Class I clostridial collagenase) and AUX-II (a Class II clostridial collagenase)]. Administered by intralesional injection, it is available in various countries for the treatment of adult men with Peyronie’s disease (PD). In two double-blind, multinational, phase III studies, CCH improved the physical (penile curvature) and psychological (patient-reported bother) aspects of PD in adult men. Such beneficial effects were also seen in two open-label, multinational, phase III studies, with potential benefits for patients’ partners and maintained efficacy over up to 5 years additionally reported. Moreover, large real-world studies generally supported the therapeutic efficacy of CCH. CCH was generally well tolerated in these patient populations, with most treatment-related adverse events [TRAEs; most commonly penile haematoma (or ‘bruising’), pain and swelling] being mild or moderate in severity, not serious and resolving without intervention. Moreover, the use of CCH was not associated with penile length shortening. Current evidence indicates that CCH is an effective, generally well tolerated and, compared with surgery, minimally invasive option for the treatment of adult men with PD.

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Acknowledgements

During the peer review process, the manufacturer of Collagenase Clostridium Histolyticum 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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    Sheridan M. Hoy

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Correspondence to Sheridan M. Hoy.

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

Conflict of interest

Sheridan Hoy is a salaried employee of Adis International Ltd/Springer Nature, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

Enhanced material for this Adis Drug Evaluation can be found at https://doi.org/10.6084/m9.figshare.9956204.

The manuscript was reviewed by:M. Bozlu, Department of Urology, University of Mersin School of Medicine, Mersin, Turkey; R. Ramasamy, Department of Urology, University of Miami, Miami, FL, USA; P. N. Tsambarlis, Rush University Medical Center, Chicago, IL, USA.

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Hoy, S.M. Collagenase Clostridium Histolyticum: A Review in Peyronie’s Disease. Clin Drug Investig 40, 83–92 (2020). https://doi.org/10.1007/s40261-019-00867-5

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