Collagenase (Xiaflex) has been approved by the FDA for treatment of Dupuytren’s contracture, after years of intensive laboratory and clinical trials. Collagenase enzymatic fasciotomy is more similar to needle fasciotomy than to either open fasciotomy or fasciectomy in terms of rapid recovery and low complication rate. Compared to needle release, collagenase enzymatic fasciotomy should eventually be more widely available (because it is easier for surgeons to learn), takes less time to perform, but provokes more inflammation and will be more expensive. Auxilium’s press release (full text: https://dupuytrens.org/DupPDFs/2010_Auxilium1.pdf) and physician prescribing information (full text: https://dupuytrens.org/DupPDFs/2010_Auxilium2.pdf) are now available. We live in exciting times for Dupuytren’s because for nearly 200 years, there has been essentially one treatment option, surgery, but within the last few years, this has expanded to also include needle release, dynamic fixation and now enzymatic fasciotomy. This has led to greater awareness of Dupuytren’s. It is now time to transform this awareness into support for efforts to develop an actual cure.
