Collagenase clostridium histolyticum is an enzyme produced by the bacterium Clostridium histolyticum that dismantles collagen. It is used as a powder-and-solvent injection kit for the treatment of Dupuytrens contracture, a condition where the fingers bend towards the palm and cannot be fully straightened, and Peyronies disease, a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis. BioSpecifics Technologies developed the preparation, which is manufactured and marketed by Endo Pharmaceuticals as Xiaflex in the US and by Sobi as Xiapex in Europe. Biochemically, it is a mixture of two C. histolyticum collagenases, ColH and ColG. A similar ointment preparation called Santyl contains one or many collagenases from the same bacterium, but it is unclear which. Uses
In February 2010, the Food and Drug Administration of the United States approved Xiaflex for the treatment of Dupuytrens contracture. It is the first approved nonsurgical treatment for this condition. In a case of Dupuytrens contracture, collagen accumulates in the palmar fascia of the hands, so that the fingers cannot be straightened. A similar phenomenon occurs in Peyronies disease, a contracture of the penis. In February 2011, the European Commissions Committee for Medicinal Products for Human Use approved the product for the treatment of Dupuytrens contracture in adults with a palpable cord by properly trained doctors. Pfizer was reported to be working with Europes national medicines regulatory bodies to launch the new treatment, hoping doctors could prescribe the treatment by late 2011.
The two collagenases act synergistically by cleaving tropocollagen (the collagen molecule) at different points. AUX-I attacks the C- and N-termini, AUX-II cleaves amino acid bonds within the molecule. Small collagen fragments are broken down by both enzymes. Interactions
No interaction studies have been conducted because the drug does not reach the bloodstream and the liver. It is theorised that drugs interfering with matrix metalloproteinases, such as tetracyclines, anthracyclines, quinolones and anthraquinone derivatives, could reduce the efficacy of the collagenases, but no clinical evidence for such an interaction has been observed. References
External links
"Collagenase clostridium histolyticum". Drug Information Portal. U.S. National Library of Medicine.