Xiaflex is a prescription medication designed to address specific conditions characterized by the presence of fibrous cords or plaques within the body. It offers a non-surgical treatment option for certain disorders that can impact mobility and function. This medication is administered through injections, directly targeting the affected tissue.
Conditions Xiaflex Addresses
Xiaflex is an FDA-approved treatment for two primary conditions: Dupuytren’s contracture and Peyronie’s disease. Dupuytren’s contracture affects the hand, causing a thickening and tightening of the connective tissue in the palm and fingers. This can lead to the formation of “cords” that pull the fingers inward, making it difficult or impossible to straighten them. Xiaflex is specifically indicated for adults with a palpable cord.
Peyronie’s disease is a condition in adult men where fibrous scar tissue, known as plaque, develops under the skin of the penis. This plaque can cause an abnormal curvature of the penis during erection, often leading to pain and interfering with sexual activity. Xiaflex is approved for men with a palpable plaque and a curvature deformity of at least 30 degrees at the start of therapy.
The Xiaflex Treatment Process
Xiaflex, containing collagenase clostridium histolyticum, works by breaking down the excess collagen that forms the cords in Dupuytren’s contracture or the plaques in Peyronie’s disease. This enzymatic disruption effectively weakens and dissolves the fibrous deposits.
The medication is administered directly into the palpable cord in the hand or the plaque in the penis by a healthcare provider experienced in these injection procedures. For Dupuytren’s contracture, a single injection is given into the cord. For Peyronie’s disease, a treatment course involves up to four cycles, with each cycle consisting of two injections given 1 to 3 days apart.
Following the injection, a physical manipulation procedure is performed to further break down the treated cord or plaque. For Dupuytren’s contracture, this occurs 1 to 3 days after the injection, where the doctor gently extends the affected finger to help rupture the weakened cord. For Peyronie’s disease, a penile modeling procedure is performed by the healthcare professional 1 to 3 days after the second injection in each cycle, involving stretching and straightening the penis.
Post-Treatment Expectations
After a Xiaflex injection, patients can expect some common side effects at or near the injection site, including swelling, bruising, pain, and tenderness. For Dupuytren’s contracture, some individuals may also experience swelling in the elbow or armpit, itching, cracked skin, or pain in the armpit. For Peyronie’s disease, common side effects can include penile hematoma, penile swelling, and penile pain.
Less common but more serious potential side effects warrant immediate medical attention. These include signs of a severe allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat. For Dupuytren’s contracture, there is a risk of tendon rupture, ligament damage, or nerve injury, which may manifest as numbness, tingling, increased pain, or difficulty bending the injected finger. For Peyronie’s disease, serious risks include penile fracture or other severe penile injury, indicated by a popping sound or sensation in an erect penis, sudden loss of erection, severe pain, or purple bruising and swelling of the penis.
The recovery period varies depending on the condition and individual response. For Dupuytren’s contracture, it takes at least a week, with full hand use returning within 2 to 4 weeks. Post-treatment care instructions include elevating the treated hand and avoiding heavy lifting for at least a week. Patients are advised to wear an extension splint at night for several weeks to months and perform daily finger exercises to regain range of motion.
For Peyronie’s disease, recovery time ranges from 2 to 4 weeks, depending on the pain and swelling. Patients are advised to avoid sexual activity between injections and for at least 4 weeks after the second injection of a treatment cycle, or until pain and swelling subside. Daily gentle stretching and straightening of the penis, known as penile modeling, is also a part of the recovery process, performed for about 6 weeks after each treatment cycle. Outcomes for Dupuytren’s contracture can include a significant reduction in contracture and improved range of motion, with studies showing a percentage of patients achieving a straight or nearly straight finger. For Peyronie’s disease, clinical trials have shown an average reduction in penile curvature.