Xiaflex for Dupuytren’s Contracture of the Hand

In a situation akin to that of collagen deposits in the penis causing curved erections, Dupuytren’s Contracture of the hand results from too much collagen in the palm’s fascia. Generally this occurs near the base of the palm and involves the forth and fifth fingers. Typical complaints include the inability to straighten these fingers resulting in a claw like position. Predominantly a disease of men with European ancestry, Dupuytren’s Contracture results from unknown causes although genetics may play a role. The once widely held view that it resulted from alcoholism or epilepsy seems largely discredited. People with the condition may develop a somewhat similar disorder on the sole of the feet. Treatment involves carefully placed injections into the affected area followed 1-3 days later with vigorous stretching therapy of the treated tissue by the practitioner. A splint worn nightly provides additional benefit. Unfortunately recurrences develop in about 50% of treated individuals. Complications occur frequently and include swelling, bruising, hemorrhage and pain. Less often allergy attacks, itching and tearing of the skin develop. Endo International acquired the manufacturer of Xiaflex in the recent past. It has a rocky road ahead with Bloomberg suggesting in January 2018 that debt is high and lawsuits plentiful. Each vial of Xiaflex carries a cash price of about $4500. Prices rose about 25% between 2015-2018.