title: The History of Collagenase Clostridium Histolyticum.
abstract: BACKGROUND
  After its U.S. FDA approval in 2013, Collagenase Clostridium histolyticum (CCh) has seen increasing use as a nonoperative treatment for Peyronie's disease (PD). We review the history of CCh and trials that led to its adoption.
  
  
  OBJECTIVE
  To provide a historical and contemporary context for the evolution of Collagenase Clostridium histolyticum as a treatment modality for Peyronie's disease.
  
  
  METHODS
  A comprehensive search of peer-reviewed literature was performed pertaining to CCh and its biochemical and clinical significance.
  
  
  METHODS
  The main outcome studied was the efficacy and safety profile of CCh in PD. CCh use in other diseases processes and its associated outcomes are also described.
  
  
  RESULTS
  CCh injection yields objective improvement in penile curvature across multiple trials in PD patients. Recently, level 1 strength of evidence has emerged supporting its widespread use. As such, CCh stands as the only FDA-approved injectable therapy for PD. Adverse events were namely limited to local reactions. Serious systemic complications and need for intervention were rare.
  
  
  CONCLUSIONS
  CCh is a safe and effective treatment for PD patients with deformities and plaque configuration amenable to injectable therapy. Multiple trials have demonstrated improvements in objective and subjective metrics such as penile curvature and bother scores. However, multiyear follow-up is needed to assess durability and its sustained clinical significance. Currently, refinement in dosing and technique has established a niche for CCh in PD patients who are affected by their symptoms but are not yet committed to surgical intervention. Yang KK and Bennett N. The history of collagenase clostridium histolyticum.
authors: Lahey Hospital and Medical CenterInstitute of UrologyBurlingtonMAUSA.
authors: Kevin K
authors: KK
authors: Yang
authors: Lahey Hospital and Medical CenterInstitute of UrologyBurlingtonMAUSA. Electronic address: nbennettjrmd@gmail.com.
authors: Nelson
authors: N
authors: Bennett
keywords: Collagenase Clostridium Histolyticum; Peyronie's Disease; Xiaflex