Here you will find the recommendations we have made about the use of individual medicines in Lancashire.

Collagenase clostridium histolyticum

Brand: Xiapex®
NICE TA: 459
Indication: Treating Dupuytren's contracture (NICE TA459)
Disease category: Musculoskeletal system
Commissioning responsibility: CCG
PbR excluded: Yes


People who meet the inclusion criteria for the ongoing clinical trial (HTA-15/102/04), comparing collagenase clostridium histolyticum (CCH) with limited fasciectomy, are encouraged to participate in the study.

For people not taking part in the ongoing clinical trial, CCH is recommended as an option for treating Dupuytren’s contracture with a palpable cord in adults only if all of the following apply:

•There is evidence of moderate disease (functional problems and metacarpophalangeal joint contracture of 30° to 60° and proximal interphalangeal joint contracture of less than 30° or first web contracture) plus up to 2 affected joints.
•Percutaneous needle fasciotomy (PNF) is not considered appropriate, but limited fasciectomy is considered appropriate by the treating hand surgeon.
•The choice of treatment (CCH or limited fasciectomy) is made on an individual basis after discussion between the responsible hand surgeon and the patient about the risks and benefits of the treatments available.
•One injection is given per treatment session by a hand surgeon in an outpatient setting.


LMMG recommendation: Red
Click here to find the definitions for the colour classifications

Reason for decision:  Specialist medicine

Supporting documents:

NICE TA459 - Collagenase clostridium histolyticum for treating Dupuytren's contracture

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG