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

Treatment of Dupuytren Contracture Recurrence After Surgery With Collagenase Clostridium Histolyticum: A Retrospective Multicenter Series. (PubMed, J Hand Surg Glob Online) - "This retrospective analysis indicates that CCH treatment is an effective and well tolerated nonsurgical option for recurrent postsurgical contracture, with results comparable to patients without prior surgery. Therapeutic III."

Journal • Retrospective data

Analysis of Last-line Treatments for Dupuytren's Contracture (AAOS 2026) - "A retrospective EMR review of Dupuytren's patients' DASH scores to determine which last-line treatment performs better: surgery, Xiaflex injection, steroid injection, or radiation."

Office-based penile plication with ring block: a safe and effective alternative to operating room-based surgery. (PubMed, J Sex Med) - No abstract available

Journal

The impact of the "bent carrot": Google search trends on Peyronie's disease increased following the introduction of collagenase clostridium histolyticum advertisement campaign. (PubMed, J Sex Med) - No abstract available

Journal

Investigating Techniques to Reduce Flexor Tendon Rupture Risk During Manipulation for Dupuytren Contracture. (PubMed, J Hand Surg Glob Online) - "Collagenase clostridium histolyticum injection and manipulation for treatment of Dupuytren contracture has a small risk of flexor tendon rupture...This study found that combining wrist flexion and remaining finger extension during manipulation decreases the force required to extend the small finger, suggesting a decrease in stress seen by the flexor tendons during manipulation. Therapeutic IV."

Journal • Fatigue

Concurrent Low Intensity Shockwave Therapy on Collagenase Clostridium Histolyticum for Peyronie's Disease (clinicaltrials.gov) - P=N/A | N=60 | Recruiting | Sponsor: Mayo Clinic | Trial completion date: Dec 2025 ➔ Jan 2027 | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Erectile Dysfunction

Retraction: In Vitro Study of Novel Collagenase (XIAFLEX®) on Dupuytren's Disease Fibroblasts Displays Unique Drug Related Properties. (PubMed, PLoS One) - No abstract available

Journal • Preclinical

Effectiveness of hyaluronic acid in the treatment of Peyronie's disease in the light of the European Urology Guidelines: the real-world experience. (PubMed, Minerva Urol Nephrol) - "Intralesional HA injections are safe and effective in improving patient's reported symptoms and subsequently quality of life in PD patients. This therapy may represent a valuable alternative in real-world clinical practice, especially in Europe where other pharmacological options are lacking."

Journal • Real-world evidence • Fibrosis • Pain • Urology

Nationwide Medicare and Medicaid Trends in Management of Dupuytren's Contracture. (PubMed, Hand (N Y)) - "Unlike international trends, US collagenase use continued to rise through 2022. Open fasciectomy remained primary, with a shift toward minimally invasive treatments and outpatient settings. Hand specialists are increasingly involved, though orthopedic surgeons lead in volume. These findings reflect evolving care models and highlight the need for continued monitoring of provider patterns and access to DC treatment."

Journal • Medicare • Reimbursement • US reimbursement • Orthopedics

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