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Proven efficacy in Dupuytren’s treatment

Xiapex has proven efficacy in the treatment of Dupuytren's contracture. Its efficacy is supported by data gathered from CORD I and CORD II.1,2 These are the largest prospective, placebo-controlled studies conducted in patients with Dupuytren’s disease to date.
The result of CORD I showed that Xiapex reduced the degree of contracture to 5 degrees or less, approximately 30 days after the last injection of the joint, in 64% of the 308 enrolled patients. This compared with the 6.8% of those injected with placebo (P < 0.001).1 Similar results were seen in CORD II (44.4 % vs 4.8 %; p<0.001).2
Xiapex shows a significantly reduction in joint contracture vs placebo
Xiapex has proven efficiacy in the treatment of Dupuytren's contracture. This efficacy is supported by data gathered from CORD I and CORD II.1,2
Significant reduction in joint contracture to 0 to 5 degrees of normal extension with Xiapex vs placebo1,2

Xiapex improves range of motion1,2
In CORD I and CORD II, range of motion (ROM) was defined as the difference between the full flexion angle and full extension angle, expressed in degrees.1,2
In CORD I (n=308), Xiapex showed a significant improvement in range of motion compared with placebo.1
Improvement in MP joint range of motion in CORD I

Xiapex showed a 29 degree mean improvement in range of motion in PIP joints (p<0.001).1 Improvements in range of motion of ≥13.5 degrees are deemed clinically relevant.
Improved range of motion was correlated with greater patient satisfaction (r=0.51, p<0.001).3
Multicord Study design4
Multicenter, open-label phase 3b study
Primary endpoint:
- Safety of two concurrent injections of Xiapex into the same hand in subjects with multiple Dupuytren’s contractures with palpable cords
- Followed 24 to 72 hours later by a finger extension procedure
Secondary endpoint:
- Evaluate the efficacy of two concurrent injections of Xiapex
Improvement in fixed flexion contracture regardless of extension day4

Similar safety profile as with treatment of one cord3,4*

* More safety details may be found here.
Patients demonstrate a high level of satisfaction when treated with Xiapex3
Based on a global assessment of treatment satisfaction, more than 85 % of patients receiving Xiapex in the CORD I and CORD II studies reported being “very satisfied” or quite satisfied”.
Greater patient satisfaction was correlated with improved range of motion.
r = 0.51, p< 0.001).
Durability of response to Xiapex demonstrated in Phase III clinical trails5
The long-term extension trial (CORDLESS) is a prospective 5 year trial examining the recurrence and long-term safety with annual interim analyses.
Recurrence was defined as:
- Contracture increased by ≥ 20o with palpable cord OR
- Medical/surgical intervention performed (i.e. if surgery/reinjection later performed)

No new safety signals were identified among subjects who were followed for 5 years after their initial injection of Xiapex.
Can treated joints be retreated?
To find out whether treated contractures can be retreated, patients from an earlier study called CORDLESS were included in an open-label phase 4 study. The patients had recurrence of contracture and a palpable cord in a joint that had been previously effectively treated.
Yes, previously treated contractures can be successfully retreated6
Percentage of patients with reduction in joint contracture to 0 to 5 degrees

References:
- Hurst LC et al. N Engl J Med. 2009;361:968–979
- Gilpin D et al. J Hand Surg. 2010;35A:2027–2038
- Xiapex Summary of Product Characteristics.
- Gaston G, et al. J Hand Surg Am. 2015;40(10):1963-71
- Peimer CA et al. J Hand Surg Am. 2015 Aug;40(8):1597-605.
- Bear BJ et al. Hand Surg Am. 2017 May;42(5):391.e1-391.e8.