NICE recommends Xiapex for treatment of Dupuytren’s disease

People in England with the disabling hand condition Dupuytren’s disease will have access to Xiapex (collagenase clostridium histolyticum or CCH) injections for contracture of their fingers, Swedish Orphan Biovitrum Ltd (Sobi) has announced. The announcement follows a recommendation for NICE for the treatment to be used on the NHS.

Xiapex was granted a marketing authorisation by the European Commission for the treatment of Dupuytren’s contracture in adult patients with a palpable cord in 2011, and was the first pharmacological treatment approved by the EU for treating this condition. It was recommended for use in Wales by the All Wales Medicines Strategy Group (AWMSG) in November 2011, and in Scotland by The Scottish Medicines Consortium (SMC) in April 2012.

Neil Dugdale, General Manager UK & Republic of Ireland at Sobi, said: “The availability of funding for Xiapex within NHS England is an important milestone for the Dupuytren’s community in the UK, as HCPs can now offer people with contracture a non-invasive treatment option.

“We are pleased that Sobi was able to work with NICE and ultimately achieve access for Dupuytren’s contracture patients in England. We are very grateful for the support of both the British Dupuytren’s Society and the British Society for Surgery of the Hand during this process.”

Anna Schurer, Chair of the British Dupuytren’s Society, said: “The British Dupuytren’s Society is delighted that after four years of meetings and deliberations, Xiapex will finally become routinely available for patients on the NHS across the UK.

“Many of our members struggle to access treatment for Dupuytren’s contracture on the NHS, including collagenase, radiotherapy and surgery in some instances and we’re pleased that non-invasive treatment of this very disabling condition is now more accessible for patients.”

NICE recommends CCH as an option for treating Dupuytren’s contracture with a palpable cord, in adults who are not taking part in an ongoing clinical trial comparing CCH to limited fasciectomy, 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
• 1 injection is given per treatment session by a hand surgeon in an outpatient setting.