Collagenase Clostridium Histolyticum: A Review in Peyronie’s Disease

Abstract

Collagenase Clostridium Histolyticum (CCH) (Xiaflex(®), Xiapex(®)) intralesional injection is a mixture of class I (AUX-I) and class II (AUX-II) clostridial collagenases. It is indicated for the treatment of adult men with Peyronie's disease with a palpable plaque and curvature deformity of ≥ 30° at the start of therapy. This article reviews the efficacy and tolerability of CCH in this indication and briefly summarizes its pharmacology. CCH treatment significantly improved penile curvature deformity and reduced patient-reported bother associated with Peyronie's disease in the 52-week, double-blind, phase III IMPRESS I and II studies. Treatment benefit with CCH was also seen in 36-week, open-label studies, providing further support for its efficacy. CCH was generally well tolerated in patients with Peyronie's disease, with most treatment-related adverse events being of mild or moderate severity. Serious treatment-related adverse events (penile haematoma or corporal ruptures) were reported in <1% of CCH recipients in clinical studies. Although further studies assessing the long-term effects of CCH intralesional injection are needed, current evidence indicates that this is a minimally invasive, effective and generally well tolerated treatment option for patients with Peyronie's disease.