Collagenase Clostridium Histolyticum (Xiaflex®)
Xiaflex® (Collagenase Clostridium Histolyticum) is a new non-surgical treatment for Dupuytren's Contracture that has recently been released in Australia. It is a TGA-approved, non-PBS prescription drug, and is indicated for the treatment of Dupuytren's contracture in adult patients with a palpable cord. It has been available in Europe, Canada and the United States for several years.
The treatment involves a minimally-invasive injection of Collagenase (Xiaflex®) administered directly into the Dupuytren's cord. The collagenase weakens the cord, allowing it to be disrupted by manual manipulation of the affected joint. Disruption of the cord decreases contracture, allowing for greater range of motion in the joint. Xiaflex® must be administered by an accredited hand surgeon, and can be given in an appropriate office-based setting.
Xiaflex® is suitable for many adult Dupuytren's patients with a palpable cord. It provides a non-surgical, less-invasive option for treatment, with reduced recovery times.
Dr Taylor is specially trained and accredited to administer collagenase injections according to the Therapeutic Goods Administration (TGA) guidelines.
The treatment process consists of the following three steps...
Step 1: Injection of Xiaflex® directly into the collagen cord of the affected joint, using a 27g needle.
Step 2: Manipulation of the affected joint under local anaesthetic, approximately 24-72 hours later. Rupture of the cord generally occurs after gentle extension, decreasing contracture and allowing for greater range of motion in the joint.
Step 3: Follow-up with the patient after 4 weeks, to monitor improvement.
What are the results?
Over 50% of patients obtain a near-straight finger at 30 days, with an average of 70-80% improvement in the contracture.
What is the cost?
Because the collagenase medication is not listed on the Pharmaceutical Benefits Scheme (PBS) it is necessary for us to pass the full cost of the medication onto our patients. Some health funds and the Department of Veterans' Affairs will provide part or full refunds for the cost of the medication. It is worthwhile asking your health fund if this applies to you (if your extras cover provide "pharmaceutical prescriptions cover" or "pharmacy cover" you are likely to be able to claim a benefit).
When comparing, bear in mind there are also significant out-of-pocket costs for surgery.
For more information please download the Xiaflex® Patient Brochure here