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

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.