Collagenase Clostridium Histolyticum (hereafter referred to as CCH) [Xiaflex®; Xiapex®] is a mixture of two Clostridium histolyticum collagenases [AUX-I (a Class I clostridial collagenase) and AUX-II (a Class II clostridial collagenase)]. Administered by intralesional injection, it is available in various countries for the treatment of adult men with Peyronie’s disease (PD). In two double-blind, multinational, phase III studies, CCH improved the physical (penile curvature) and psychological (patient-reported bother) aspects of PD in adult men. Such beneficial effects were also seen in two open-label, multinational, phase III studies, with potential benefits for patients’ partners and maintained efficacy over up to 5 years additionally reported. Moreover, large real-world studies generally supported the therapeutic efficacy of CCH. CCH was generally well tolerated in these patient populations, with most treatment-related adverse events [TRAEs; most commonly penile haematoma (or ‘bruising’), pain and swelling] being mild or moderate in severity, not serious and resolving without intervention. Moreover, the use of CCH was not associated with penile length shortening. Current evidence indicates that CCH is an effective, generally well tolerated and, compared with surgery, minimally invasive option for the treatment of adult men with PD.

Clinical drug investigation. 2019 Oct 18 [Epub ahead of print]

Sheridan M Hoy

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