Collagenase Clostridium Histolyticum (Injection)

Predominantly used to treat Dupuytren's contracture, Collagenase Clostridium Histolyticum is used to dismantle collagen.

Overview

Delivered via injection, Collagenase Clostridium Histolyticum is an enzyme and is mainly used to treat Dupuytren's contracture. Affecting the fingers and hands, Dupuytren's contracture causes the fingers to bend in, towards the palm of the hand. Although the condition can just affect one finger, it may affect many or all fingers and can occur on both hands.

Believed to be caused by an excess of connective tissue in the hand, abnormal nodules grow under the skin. When these grow larger, these nodules form cords of tissue. If these cords are located along the finger or thumb, they can draw the digit in towards the palm when they shorten.

Although Dupuytren's contracture does not always cause pain, it can affect the patient's day-to-day activities. Due to this, treatment is required. Whilst surgical procedures may be used to treat severe cases of Dupuytren's contracture, this can be avoided by using Collagenase Clostridium Histolyticum injections to treat the condition instead.

Produced by the Clostridium Histolyticum bacteria, Collagenase Clostridium Histolyticum breaks down collagen. Rather than being injected into the fingers or thumb, Collagenase Clostridium Histolyticum is injected into the excess tissue running through the hand. By dissolving this excess collagen, the fingers and/or thumb are no longer pulled in towards the palm and the patient's hand gradually returns to a normal condition.

In addition to being used to treat Dupuytren's contracture, Collagenase Clostridium Histolyticum injections can also be used to treat Peyronie's disease. Affecting male patients, Peyronie's disease occurs when abnormal plaques grow in the soft tissue of the penis. This excess tissue can cause curvature of the penis, abnormal indentation and/or erectile dysfunction in some patients.

By using Collagenase Clostridium Histolyticum injections, physicians can dissolve the plaques of tissue which have formed. When these are no longer present, they do not cause the penis to curve abnormally and, in many cases, erectile dysfunction is resolved.

Although Collagenase Clostridium Histolyticum injections are currently used in the treatment of Dupuytren's contracture and Peyronie's disease, they may be used to treat Garrod's pads and plantar fibromatosis in the future.

Despite being a relatively new form of treatment, Collagenase Clostridium Histolyticum injections can be extremely effective in treating the above conditions and are well-tolerated by most patients.

Conditions Treated

Type of Medicine

  • Protein-Based Therapy

Side Effects

Although treatment with Collagenase Clostridium Histolyticum injections is not associated with a vast amount of adverse effects, patients may notice some side-effects after receiving treatment. If Collagenase Clostridium Histolyticum injections have been used to treat Dupuytren's contracture, for example, patients may notice:

  • style="font-weight: 400;">Tender, painful or swollen lymph glands in their armpit and/or neck
  • Burning, coldness, discoloration, blistering at site of the injection
  • 400;">Hives, inflammation, feeling of pressure, stinging or tingling at site of injection
  • Bruising
  • Redness or flushing at the skin at the infection site

Generally, these side-effects are relatively mild and do not last for a particularly long time after the Collagenase Clostridium Histolyticum injection has been administered. Despite this, patients should always seek medical advice if they are concerned about any side-effects they're experiencing.

If patients notice any of the following side-effects after receiving Collagenase Clostridium Histolyticum injections for Dupuytren's contracture, they should always seek medical advice:

  • Bone pain
  • Pain in lower back or side
  • Swollen and/or painful joints
  • Tearing of the skin
  • Swollen hands
  • Bleeding or bruising at the site of the injection

Similarly, if patients experience any of the following side-effects after receiving Collagenase Clostridium Histolyticum for Peyronie's disease, they should seek medical advice:

  • Lack of interest in sexual intercourse
  • Loss of sexual desire, ability, performance and/or drive
  • Inability to have or keep an erection
  • Pain during sexual intercourse
  • Pain, swelling, redness or bruising on the penis
  • Popping sensation or sound in erect penis

In addition to this, patients should seek medical advice if they experience any other side-effects after receiving treatment with Collagenase Clostridium Histolyticum injections.

Dosage

When Collagenase Clostridium Histolyticum injections are prescribed, the strength of the solution will depend on what the patient is being treated for. If patients are given Collagenase Clostridium Histolyticum injections for Dupuytren's contracture, they are likely to be injected with a solution containing 0.58mg. If necessary, each contracture can be treated with further 0.58mg injections but these are usually carried out at least 4 weeks apart. In most cases, treatment can be carried out up to a maximum of 3 times on each contracture.

Alternatively, for treatment of Peyronie's disease, patients may be given two Collagenase Clostridium Histolyticum injections at a strength of 0.58mg. These injections are usually administered 1-3 days apart. If necessary, this treatment process can be carried out again, up to a maximum of four times. Typically, patients should wait at least 6 weeks between treatment cycles.

Although these are standard treatment guidelines, every patient will receive an individual treatment regime based on their condition, medical history, age and weight. Patients should always follow their doctor's instructions when undergoing any type of treatment.

For treatment of Dupuytren's contracture:

If patients are receiving Collagenase Clostridium Histolyticum injections for Dupuytren's contracture, their hand will be bandaged after the injection has been administered. Unless otherwise advised, patients should try not to use or move the finger which has been treated.

Patients should have a follow-up consultation within 1-3 days of receiving Collagenase Clostridium Histolyticum injections for Dupuytren's contracture. This will enable the physician to assess the effects of the injection and perform a finger extension exercise, if it is necessary.

After receiving Collagenase Clostridium Histolyticum injections, patients should elevate the hand as this can help prevent swelling from occurring. Patients should not attempt to bend or extend the fingers of the hand, nor should they attempt to massage the palm of their hand. In some cases, patients may be advised to wear a splint during the night on the affected hand for a period of up to four months.

In addition to this, doctors may provide the patient with an exercise regime to encourage the affected fingers to return to their normal position. It is important, however, that patients only carry out exercises which have been recommended by their doctor.

For treatment of Peyronie's disease:

After receiving a Collagenase Clostridium Histolyticum injection, the patient's penis may be bandaged. Patients should leave this bandaged on until their doctor advises them to remove it. Patients should return to their physician within 1 -3 days to receive the second injection and complete the rest of the treatment cycle.

Following this, patients will be required to see their doctor again within 1-3 days of the second injection. This will enable the physician to assess the efficacy of the treatment and carry out further straightening procedures, if they are required.

Patients should not engage in any sexual activity between the administration of the first and second injections. Following the second injection, patients should not engage in any sexual activity for at least two weeks and should not have sexual intercourse until the pain and swelling has subsided.

Warnings

Collagenase Clostridium Histolyticum injections have not been associated with specific drug interactions but patients should inform their doctor if they are using any other medicines. This may include over-the-counter medicines, vitamins and/or supplements. Patients should seek medical advice before using any of these substances after receiving Collagenase Clostridium Histolyticum injections.

Patients should discuss their medical history and existing conditions with their physician prior to receiving treatment. If patients have blood clotting disorders, for example, Collagenase Clostridium Histolyticum injections may not be a suitable form of treatment for them. Similarly, Peyronie's disease with plaques in the penile urethra, as opposed to the soft tissue, should not be treated with Collagenase Clostridium Histolyticum injections.

It is not yet known whether Collagenase Clostridium Histolyticum injections are safe for use on children. If young patients have been diagnosed with Dupuytren's contracture, they may be offered alternative treatment. Collagenase Clostridium Histolyticum injections should only be used if the benefits of treatment clearly outweigh the potential risks.

If women are treated for Dupuytren's contracture, they should inform their physician if they are pregnant or plan to become pregnant. The safety of Collagenase Clostridium Histolyticum injections for pregnant patients has yet to be confirmed. Although it is not thought to present a specific risk, Collagenase Clostridium Histolyticum injections should only be administered to pregnant patients if treatment is essential. In most cases, physicians do not recommend Collagenase Clostridium Histolyticum injections as a suitable treatment for pregnant patients.

Similarly, it is not known if Collagenase Clostridium Histolyticum can pass from a mother to child via breastfeeding. Due to this, patients are normally advised not to breastfeed if they are receiving treatment with Collagenase Clostridium Histolyticum. Patients should discuss any potential risks with their doctor before receiving treatment.

If patients have any established allergies, they should inform their physician before receiving treatment. Even allergies which are not related to medical substances should be noted. If patients suspect they are experiencing an allergic reaction whilst receiving treatment or following a Collagenase Clostridium Histolyticum injection, they should seek medical help immediately.

Storage

Usually, Collagenase Clostridium Histolyticum is provided in a single-use vial and should be stored alongside a diluent, ready for reconstitution. In most cases, the vials and diluent should be stored in a refrigerator, between temperatures of 2°-8°C (36°-46°F).

Once the Collagenase Clostridium Histolyticum solution has been prepared, however, it can be stored at room temperature for one hour. Room temperature should be between 25°-25°C (68°-77°F). Alternatively, the solution can usually be kept in a refrigerator at temperatures of 2°-8°C (36°-46°F) for up to four hours.

As Collagenase Clostridium Histolyticum injections are administered by a healthcare professional, the patient should be in a clinical setting when they receive treatment. Patients will not, therefore, have to store or prepare the solution as this will be managed by appropriately trained medical staff.

Summary

Although Dupuytren's contracture and Peyronie's disease may not cause the patient pain, they can have a significant effect on the patient's life. While Peyronie's disease can make sexual intercourse difficult or impossible, Dupuytren's contracture can prevent the patient from using their hands effectively.

As both conditions are caused by excess tissue presenting in a localized area, they can both be treated with Collagenase Clostridium Histolyticum injections. By dissolving the extra tissue, Collagenase Clostridium Histolyticum injections can prevent the surrounding structures from being pulled out of place. With successful treatment, these injections can resolve both Peyronie's disease and Dupuytren's contracture quickly and effectively.