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Xiapex injections

Table of Contents

What is Xiapex?

Xiapex ® is the trade name of collagenase clostridium hystiolyticum which is produced naturally from a bacterium called clostridium histolyticum. The medicine contains special proteins (enzymes) that break up the collagen fibres in the cord. Following an injection of Xiapex into the Dupuytren’s cord, this leads to weakening of the cord, eventually allowing the bent finger(s) to be straightened.

The injection is followed by a procedure 2-5 days later during which the finger is extended by the doctor, breaking the cord. In some cases, the cord breaks on its own so the extension procedure is not needed.

This treatment does not require the patient to stay in hospital. Anaesthetic is not needed for the injection, although local anaesthetic may be used for the extension procedure.

Xiapex® was granted a marketing authorisation by the European Commission for the treatment of Dupuytren’s contracture in adult patients with a palpable cord in 2011, and was the first pharmacological treatment approved in the EU for treating this condition

How is Xiapex adminstered?

xiapex flow diagram

Clinical Results of Xiapex


Can things go wrong with Xiapex treatment?

Xiapex treatment has potential risks and possible complications that need to be considered along with the potential benefits of this method of treatment. Just as Dupuytren’s surgery has possible significant complications so does Xiapex treatment.

Complications are fortunately quite rare in Xiapex treatment. However they still can occur.

Complications include pain, stiffness, complex regional pain syndrome, infection, nerve injury, neuroma formation, significant skin tears, scar pain, tendon injury or complete tendon rupture, vascular injury, worsening of symptoms, residual symptoms and joint instability, haematoma or worsening of original symptoms.

Dupuytren’s contracture may also recur (come back) in the future and require further treatment. Currently, it is not possible to say exactly how long it could be before Dupuytren’s contracture might recur. This as it will depend on a series of factors, including: the patient’s individual circumstances; stage and severity of the condition and whether that person has had previous treatment for Dupuytren´s contracture and their response for treatment.

Major allergic reactions have been reported after Xiapex treatment similar to after other medications and injections.

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Patient information leaflet