A Nonsurgical Option

What is XIAFLEX®?

XIAFLEX® is an FDA-approved, nonsurgical treatment for adults with Dupuytren’s contracture when a “cord” can be felt. It starts breaking down the cord as soon as you receive the first injection.

XIAFLEX® should be injected by a healthcare provider who is experienced in injection procedures of the hand and in treating people with Dupuytren’s contracture.

XIAFLEX® can cause serious side effects such as tendon rupture or ligament damage.

How is XIAFLEX® given?

XIAFLEX® is given:

  • In a doctor’s office
  • By a hand specialist with XIAFLEX® training
  • With no general anesthesia required

How can XIAFLEX® help?

Studies show that prescription XIAFLEX®, along with a finger extension procedure, may help straighten or nearly straighten the affected finger and improve range of motion after up to 3 injections.

83% (206 out of 249) of patients were satisfied with XIAFLEX® compared with 30% (38 out of 125) of patients with placebo.*

*In 2 clinical studies, patients were asked to rate their satisfaction with treatment on Day 90 as “very satisfied,” “quite satisfied,” “neither satisfied nor dissatisfied,” “quite dissatisfied,” or “very dissatisfied.” For data analysis, “satisfied” includes patients who chose “very satisfied” or “quite satisfied.”

In these 2 clinical studies, patients received up to 3 injections of XIAFLEX® or placebo into a cord that could be felt on Days 0, 30, and 60. About 24 hours after each injection, patients had a finger extension procedure and were fitted with a splint to wear at bedtime for up to 4 months. Patients also performed finger exercises every day.

In these 2 studies, 60% of patients had a straight or nearly straight finger 30 days after the last injection on Days 30, 60, or 90 after up to 3 XIAFLEX® injections and finger extension procedures compared with 6% of patients who received placebo.

The most common side effects with XIAFLEX® in these studies were swelling of the injected hand and bruising or bleeding at the injection site.

Real-world XIAFLEX® results

Treatment of one contracture

This patient had a cord that could be felt causing a contracture of the MP joint of the left ring finger. The cord was injected with XIAFLEX® and a finger extension procedure was performed 48 hours later

A hand with Dupuytren's contracture before a XIAFLEX® injection.

BEFORE TREATMENT

A hand with Dupuytren's contracture after a XIAFLEX® injection.

AFTER FINGER EXTENSION

Actual patient. Images used with permission from physician and patient.

MP=metacarpophalangeal Individual results may vary

Treatment of one contracture

This patient had a cord that could be felt causing a contracture of the PIP joint of the left pinky finger. The cord was injected with XIAFLEX® and a finger extension procedure was performed 48 hours later

A hand with Dupuytren's contracture before a XIAFLEX® injection.

BEFORE TREATMENT

A hand with Dupuytren's contracture after a XIAFLEX® injection.

AFTER FINGER EXTENSION

Actual patient. Images used with permission from physician and patient.

PIP=proximal interphalangeal Individual results may vary

Treatment of two contractures on the same hand

This patient had a cord that could be felt causing contractures of the MP and PIP joints of the left pinky finger. The cord was injected with XIAFLEX® at each location and a finger extension procedure was performed for each joint 48 hours later

A hand with Dupuytren's contracture before a XIAFLEX® injection.

BEFORE TREATMENT

A hand with Dupuytren's contracture after a XIAFLEX® injection.

AFTER FINGER EXTENSION

Actual patient. Images used with permission from physician and patient.

MP=metacarpophalangeal PIP=proximal interphalangeal Individual results may vary

Patients had finger extensions performed by a physician; were fitted with a splint; and were instructed to use a splint at bedtime for up to 4 months and perform daily finger exercises.

In studies, patients received up to 3 injections of XIAFLEX® or placebo into a cord that could be felt at approximately 4-week intervals.

The most common side effects with XIAFLEX® for the treatment of Dupuytren’s contracture include swelling of the injection site or the hand; bruising or bleeding at the injection site; pain or tenderness of the injection site or the hand; swelling of the lymph nodes (glands) in the elbow or armpit; itching; breaks in the skin; redness or warmth of the skin; pain in the armpit.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects with XIAFLEX®. For more information, ask your healthcare provider or pharmacist.

Is XIAFLEX® right for me?

A hand specialist may consider treatment with XIAFLEX® if you have a cord that can be felt, along with:

Contractures ranging from less severe to more severe

Multiple contractures in 1 hand
Up to 2 cords in 1 hand may be treated during 1 office visit.

Contractures that have come back
Dupuytren’s contracture may come back no matter what option you use. If your condition returns after treatment, nonsurgical XIAFLEX® may be used again.

Ask a hand specialist if XIAFLEX® is right for you.

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Understanding the Procedure

Receiving XIAFLEX®

Treatment with XIAFLEX® is performed in a doctor’s office.

Considering treatment with XIAFLEX®? The following steps can help you better understand what to expect.

XIAFLEX® should be injected by a healthcare provider who is experienced in injection procedures of the hand and treating people with Dupuytren's contracture.

Use these questions to help guide your discussion with a hand specialist.

Download discussion guide
Step 1
Step 2
Step 3

Receiving XIAFLEX® injection

The doctor will:

  • Inject XIAFLEX® directly into the cord that is causing your finger(s) to bend
    • If you have more than 1 contracture, your doctor may give you 2 injections in 1 of your hands during your visit
  • Wrap your treated hand with bandages
  • Advise you to keep your hand elevated until bedtime
  • Advise you to limit the movement of your treated finger(s)

Do not bend or straighten the treated finger(s) yourself

Extending your finger(s)

Your first follow-up visit with the doctor will be approximately 1 to 3 days after the injection. If you still have the cord, the doctor may try to extend the treated finger(s) and “break” the cord. This is to help straighten your finger(s). The doctor may use local anesthetic during this procedure.

After the extension procedure, the doctor will:

  • Ask you to do simple finger exercises daily after the procedure
  • Instruct you to wear a splint at bedtime
  • Advise you how long to wait before resuming normal activities with the treated hand

Checking your progress

  • Return to the doctor about 30 days after the injection to have your finger(s) examined
  • Depending on your results, or if the cord(s) is still present, you may need additional injections and finger extension procedures (up to 3 times per cord), approximately 4 weeks apart

Call the doctor right away if you have:

  • Signs of infection after your injection, such as fever, chills, increased redness, or swelling
  • Numbness or tingling in the treated finger(s)
  • Trouble bending the injected finger(s) after the swelling goes down
  • Tears in the skin of your treated finger(s)

Note: Dupuytren’s contracture may return no matter what treatment is used.

Caring for your hand

Learn how to do after-treatment exercises for your hand

The following are examples of finger exercises you can do at home. This information should not take the place of talking with your doctor or healthcare professional. If you have any questions, talk to your doctor.

Exercise 1:

Lay your hand flat on the table. Raise each finger up one at a time and hold for 5 seconds. Repeat 10 times. Repeat this exercise 4 times a day.

hand raising one finger up

Exercise 2:

Lay your hand flat on the table. Move each finger from side to side (like a windshield wiper) one at a time; repeat 10 times. Repeat the exercise 4 times a day.

hand moving each finger from side to side

Exercise 3:

Bend only the top 2 joints of all fingers, keeping your knuckles straight. Arch your knuckles back 10 times in a row. Repeat the exercise 4 times a day.

hand bending only the top 2 joints of all fingers

Exercise 4:

Use the unaffected hand to gently straighten the affected finger 10 times, holding for 5 to 10 seconds. Repeat the exercise 4 times a day.

unaffected hand gently straightening the affected finger
Download the finger exercises

Ask a hand specialist if XIAFLEX® is right for you.

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IMPORTANT SAFETY INFORMATION FOR XIAFLEX®
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Do not receive XIAFLEX® if you have had an allergic reaction to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX®.

XIAFLEX® can cause serious side effects, including:

  • Tendon rupture or ligament damage. Receiving an injection of XIAFLEX® may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit
  • Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit
  • Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX® because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX®:
    • hives
    • swollen face
    • breathing trouble
    • chest pain
    • low blood pressure
    • dizziness or fainting
  • Increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX®. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX® may not be right for you.

Before receiving XIAFLEX®, tell your healthcare provider if you have had an allergic reaction to a previous XIAFLEX® injection, or have a bleeding problem or any other medical conditions. Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Using XIAFLEX® with certain other medicines can cause serious side effects. Especially tell your healthcare provider if you take medicines to thin your blood (anticoagulants). If you are told to stop taking a blood thinner before your XIAFLEX® injection, your healthcare provider should tell you when to restart the blood thinner. Ask your healthcare provider or pharmacist for a list of these medicines if you are unsure.

The most common side effects with XIAFLEX® for the treatment of Dupuytren’s contracture include:

  • swelling of the injection site or the hand
  • bruising or bleeding at the injection site
  • pain or tenderness of the injection site or the hand
  • swelling of the lymph nodes (glands) in the elbow or armpit
  • itching
  • breaks in the skin
  • redness or warmth of the skin
  • pain in the armpit

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects with XIAFLEX®. For more information, ask your healthcare provider or pharmacist.

WHAT IS XIAFLEX®?

XIAFLEX® is a prescription medicine used to treat adults with Dupuytren’s contracture when a “cord” can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18.

Please see the full Prescribing Information, including Medication Guide.

IMPORTANT SAFETY INFORMATION FOR XIAFLEX®

Do not receive XIAFLEX® if you have had an allergic reaction to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX®.

XIAFLEX® can cause serious side effects, including:

  • Tendon rupture or ligament damage. Receiving an injection of XIAFLEX® may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit
  • Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit
  • Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX® because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX®:
    • hives
    • swollen face
    • breathing trouble
    • chest pain
    • low blood pressure
    • dizziness or fainting
  • Increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX®. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX® may not be right for you.

Before receiving XIAFLEX®, tell your healthcare provider if you have had an allergic reaction to a previous XIAFLEX® injection, or have a bleeding problem or any other medical conditions. Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Using XIAFLEX® with certain other medicines can cause serious side effects. Especially tell your healthcare provider if you take medicines to thin your blood (anticoagulants). If you are told to stop taking a blood thinner before your XIAFLEX® injection, your healthcare provider should tell you when to restart the blood thinner. Ask your healthcare provider or pharmacist for a list of these medicines if you are unsure.

The most common side effects with XIAFLEX® for the treatment of Dupuytren’s contracture include:

  • swelling of the injection site or the hand
  • bruising or bleeding at the injection site
  • pain or tenderness of the injection site or the hand
  • swelling of the lymph nodes (glands) in the elbow or armpit
  • itching
  • breaks in the skin
  • redness or warmth of the skin
  • pain in the armpit

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects with XIAFLEX®. For more information, ask your healthcare provider or pharmacist.

WHAT IS XIAFLEX®?

XIAFLEX® is a prescription medicine used to treat adults with Dupuytren’s contracture when a “cord” can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18.

Please see the full Prescribing Information, including Medication Guide.