Xiaflex (collagenase clostridium histolyticum) / Asahi Kasei, SOBI, Endo - LARVOL DELTA

Cost Consideration for the Treatment of Peyronie's Disease: A Narrative Review. (PubMed, Curr Urol Rep) - "Current treatment modalities include penile traction therapy (PTT), Collagenase Clostridium histolyticum (CCh) injections, and surgical straightening procedures which have varying levels of expected deformity correction and associated side effects...More research remains to be performed to consider cost-effectiveness of various treatment options for PD patients while taking into account efficacy, opportunity cost, and patient quality of life. Urologists treating patients with PD must understand the economic aspects of the evolving treatment landscape to effectively guide management for each patient to enhance quality of life and patient outcomes."

Journal • Review • Erectile Dysfunction • Pain

Penile Traction Therapy for Peyronie's Disease: A Contemporary Narrative Review of Clinical Evidence and Evolving Trends. (PubMed, Cureus) - "Adjunctive use of PTT with collagenase Clostridium histolyticum (CCH) enhanced curvature correction by an additional 5-10% compared to CCH alone...When combined with pharmacological or injection therapies, PTT provides synergistic benefits and may delay or prevent surgical intervention. Continued multicentre research is essential to standardise protocols, evaluate long-term durability, and incorporate psychosocial outcomes into treatment assessment."

Journal • Review • CNS Disorders • Dermatology • Erectile Dysfunction • Fibrosis • Rheumatology

History of Peyronie's disease: from early descriptions to modern treatments. (PubMed, Sex Med Rev) - "A review of the historical progression of PD management demonstrates the shift from anecdotal claims of treatment efficacy to evidence-based practice. Current guidelines recommend ILI and PTT as first-line nonsurgical management, with surgery providing exceptional outcomes. Future progress aims to gain a greater molecular understanding of fibrosis and tissue remodeling to foster targeted therapies."

Journal • Erectile Dysfunction • Fibrosis • Immunology

A survey to assess practice patterns among clinicians administering collagenase Clostridium histolyticum for Peyronie's disease. (PubMed, J Sex Med) - No abstract available

Journal

STRIDE: Study to Assess EN3835 in the Treatment of Plantar Fibromatosis (Also Known as Ledderhose Disease) (clinicaltrials.gov) - P3 | N=418 | Recruiting | Sponsor: Endo Pharmaceuticals | Trial completion date: Nov 2025 ➔ Mar 2026 | Trial primary completion date: Nov 2025 ➔ Mar 2026

Trial completion date • Trial primary completion date • Fibrosis • Solid Tumor

IGF-I Transforms Fibrosis into Fat: IGF-I Induced Transdifferentiation of Dupuytren's Myofibroblasts into Adipocyte-Like Cells (PSTM 2025) - "Current standard treatment options involve excising or breaking down the fibrotic tissue – either via palmar fasciectomy or injection of collagenase clostridium histolyticum... This study offers mechanisms for discovering new therapeutic targets for treating skin fibrosis, using Dupuytren disease as a model with possible implications in other fibrotic conditions. Identifying IGF-I as a functional replacement for PRP in inducing transformation of DMFs to adipocyte-like cells in vitro is both a novel and important finding given the translational limitations of PRP as a treatment modality. However, the use of ASCs has similar limitations."

Fibrosis • Immunology • IGF1

Late-Onset Penile Fracture After Collagenase Clostridium histolyticum Treatment for Peyronie's Disease in a 70-Year-Old Patient. (PubMed, Case Rep Urol) - "This is only the third reported case occurring 30 days after injection. While the risk of penis fracture likely decreases with time, these cases illustrate that the risk may extend beyond 4 weeks."

Journal • Musculoskeletal Diseases • Orthopedics

Factors associated with improved curvature outcomes with collagenase clostridium histolyticum for Peyronie's disease: results from a large prospective series. (PubMed, J Sex Med) - "Several baseline and treatment-related factors correlate with CCH outcomes. These data may assist both patients and providers as they relate to patient selection and counseling. The data also suggest the importance of patient motivation and active participation during the treatment course."

Journal • Musculoskeletal Diseases

The Cost-Effectiveness of Collagenase Injection versus Limited Fasciectomy for Moderate Dupuytren's Contracture: An Economic Evaluation of the DISC Trial and a Decision Analytical Model. (PubMed, Value Health) - "Collagenase was less costly and less effective than LF in treating DC. The cost-effectiveness of collagenase compared to LF was time-dependent. Collagenase was highly cost-effective one-year post-treatment, but the probability of collagenase being cost-effective declined over time. The Markov model suggested that LF is more cost-effective over a lifetime horizon. These findings emphasise the importance of longer follow-up when comparing surgical and nonsurgical interventions to fully capture overall costs and benefits."

HEOR • Journal

Determining Risk Factors and Rate of Surgery After Collagenase Injections for Dupuytren Contracture. (PubMed, J Hand Surg Glob Online) - "Further research is warranted to explore mechanisms underlying progression to surgery and prevention strategies. Prognostic/III."

Journal • Addiction (Opioid and Alcohol) • Cardiovascular • CNS Disorders • Diabetes • Epilepsy • Metabolic Disorders

Review of Current Non-Invasive Peyronie's Disease Management: A Changing Reality. (PubMed, Arch Esp Urol) - "Collagenase Clostridium Histolyticum (CCH) is the only Food and Drug Administration (FDA)-approved treatment available, and its withdrawal has removed a promising first-line treatment option for PD. Emerging evidence suggests that penile traction therapy may enhance treatment outcomes and is a promising complementary approach in future therapeutic strategies."

Journal • Review • Fibrosis

"Collagenase injections versus limited fasciectomy in treating patients with Dupuytren's contracture: A systematic review and meta-analysis". (PubMed, Int J Orthop Trauma Nurs) - "LF is superior in reducing recurrence and residual contracture but has a higher complication rate. CCH yields greater change in ED. Further research is needed to refine treatment strategies."

Journal • Retrospective data • Review

Efficacy and safety of collagenase clostridium histolyticum in treating primary hourglass deformities in atypical Peyronie's disease patients. (PubMed, J Sex Med) - No abstract available

Journal • Sexual Disorders

Early postinterventional clinical implications of Collagenase Clostridium Histolyticum injection versus limited fasciectomy for Dupuytren's disease. (PubMed, J Hand Microsurg) - "The results of this study suggest that CCH injections lead to less complicated wound healing requiring less intensive surgeon and hand therapy aftercare than LF. CCH represents a valuable addition to Dupuytren's disease treatment, allowing for repeated use in severe, complex, or recurrent cases without increasing procedure-related risks while offering versatility for combination with minimally invasive surgery."

Journal

Outcomes of limited fasciectomy, needle fasciotomy and collagenase injection for Dupuytren's disease: a systematic review and meta-analysis of individual patient data. (PubMed, J Hand Surg Eur Vol) - "This systematic review and meta-analysis of individual patient data evaluates the outcomes of treatment for Dupuytren's disease using limited fasciectomy (LF), percutaneous needle fasciotomy (PNF) and collagenase clostridium histolyticum (CCH) injection...Overall, the clinically relevant contracture correction was comparable between LF, PNF and CCH, but CCH had a higher risk of minor complications and LF had the longest time to recurrence. Treatment decisions should consider the trade-off between complications and recurrence risk."

Journal • Retrospective data

The Impact of Emerging Therapies and Declining Physician Reimbursement on Dupuytren Disease Treatment: A 21-Year Review. (PubMed, J Hand Surg Am) - "The growing use of CCH as the dominant treatment for DC underscores how marketing and public awareness may influence treatment practices. Physicians have a responsibility to understand these influences, ensuring that treatment decisions are guided by clinical efficacy and cost-effectiveness while managing patient expectations and prioritizing long-term outcomes over trends driven by marketing."

Journal • Reimbursement • US reimbursement

Commentary on "Outcomes and management of Peyronie's disease with combined treatment of collagenase clostridium histolyticum, vacuum erection device, and tadalafil". (PubMed, Asian J Androl) - No abstract available

Journal

Editorial comment on "Outcomes and management of Peyronie's disease with combined treatment of collagenase clostridium histolyticum, vacuum erection device, and tadalafil". (PubMed, Asian J Androl) - No abstract available

Journal

Outcomes and management of Peyronie's disease with combined treatment of collagenase clostridium histolyticum, vacuum erection device, and tadalafil. (PubMed, Asian J Androl) - "Minor complications were observed in 15 patients, while 13 were dissatisfied with treatment, with six opting for surgery. The modified protocol demonstrated significant improvements in penile curvature and erectile function with minimal complications, offering a safe, cost-effective alternative to traditional intensive treatments."

Journal • Erectile Dysfunction • Pain • Rheumatology • Urology

Are patients undergoing intralesional collagenase Clostridium histolyticum injection therapy for Peyronie's disease compliant? A 7-year analysis from a tertiary care men's health center. (PubMed, J Sex Med) - "Overall compliance rate for CCH injection therapy was 70.89%. Greater curvature reduction was demonstrated in compliant patients. Common reasons for incomplete treatment included adverse effects (15.1%), early satisfaction with results (14.1%), and unknown factors (45.4%). However, missing data and bias from retrospective design are major limitations."

Journal • Pain

Response to Intralesional Collagenase Clostridium Histolyticum in Peyronie's Disease Patients with Concomitant Dupuytren's Contractures (AUA 2025) - "This study provides the first robust evidence that concomitant DC is associated with a superior response to CCH therapy in PD patients. The significantly greater curvature correction in the DC group suggests a potential synergistic effect of DC on CCH efficacy, meriting further investigation. These findings could influence clinical decision-making and patient counseling for men with PD and concurrent DC."

Clinical

Efficacy of a Novel Collagenase Clostridium Histolyticum Protocol for Peyronie's Disease Among Prior Non-responders: A Randomized, Controlled, Single-Blinded Study (AUA 2025) - P4 | "Men were randomized 3:1 to receive either CCH+traction (RestoreX)+sildenafil (treatment) up front or initial observation followed by treatment (controls). Repeating CCH using a novel protocol after an initially unsuccessful course of CCH achieves significant improvements in curvature and patient satisfaction. Additional data, including external validation, are warranted."

Clinical

Peyronie's disease outcomes following collagenase clostridium histolyticum may not differ by sexual orientation. (AUA 2025) - "In this series, patients who identified as MSM were with significantly higher rates of penile fracture following CCH. However, rates of complications requiring intervention, treatment satisfaction, and change in penile curvature were not statistically different in this population. While further work is needed to examine the use of CCH in this population, this data suggests that CCH may be used safely and with similar expected outcomes in the population of MSM."

Musculoskeletal Diseases

Efficacy And Safety Of Collagenase Clostridium Histolyticum Treatment In Patients With Complex Penile Plaques (AUA 2025) - "CCH injections significantly improved penile curvature in all plaque location groups, with no significant difference in the rate of most side effects between these five groups."

Clinical • Erectile Dysfunction • Musculoskeletal Diseases • Pain • Rheumatology

Injection therapy in the acute phase of Peyronie's disease: a systematic review of current evidence. (PubMed, J Sex Med) - "Injection therapy for the acute phase of PD demonstrates variable efficacy depending on the agent used and a relatively favorable safety profile; however, the overall quality of evidence remains low and is characterized by significant methodological limitations."

Journal • Pain