Clinical Outcomes of Xiaflex

Background  - Xiaflex is the enzyme collagenase clostridium histolyticum which is used to breakdown dupuytren cords.  The enzyme is injected into the cords then two days following the injection a manipulation is performed to complete the rupture of the injected cord.

Problem - Xiaflex is a relatively new treatment option for dupuytren’s and the results of Xiaflex used in clinical practice have not been widely reported.  This paper reports the authors experience with Xiaflex used in our clinical practice to treat patients with symptomatic dupuytrens contracture.

With the increase in the use of collagenase clostridium histolyticum injections to treat Duputyren’s disease the clinical efficacy and complications with regards to hand therapy has not been clearly documented.

Intervention - The authors looked to examine the clinical outcomes of patients who received collagenase clostridium histolyticum injections. Patients who received the Xiaflex treatment from common specialist referrers had several measures recorded.  Initial active range of motion, splint design, presences of skin tears, number of appointments, age and treating specialist, subsequent appointment active range of motion were all documented. Our results showed significant reduction in initial contracture and range of motion.

 Recommendations - Collagenase clostridium histolyticum injections proved safe and efficacious however, long-term effects of repeat injections and contracture recurrence rates have yet to be examined.