Is the drug Xiaflex worth getting excited about as a Dupuytrens treatment?

I’ve been reading that Xiaflex (used for Dupuytren’s contracture) was tested for Peyronie’s disease with pretty successful results and could be on the market as early as this year. Should I get my hopes up? Is this worth being excited about?

 

Greetings,

I am hearing more and more about nasty side effects and bad reactions from Xiaflex injections for Dupuytren contracture.  I think this is – or should be – the reason that Xiaflex has not been given fast approval as a Peyronie’s treatment.  I have spoken to people whose muscles and tendons have been injured (dissolved by the enzymes in Xiaflex) and the many problems they have to deal with as a result of these injuries. 

From the tone of your email I get the sense that you are genuinely hopeful about Xiaflex might do for you, because you feel so helpless against Peyronie’s disease.  Most men feel this way. You can get your hopes up, and you can get excited about it, if you wish.  Many people are sitting around waiting for a medical miracle cure while their lives slip away with a curved penis or useless hands.  They have the attitude that if there is no drug to save them, there is nothing to help them because the body cannot do anything against Peyronies disease or Dupuytren contracture.  Personally, I do not accept that line of thought.  I have seen too many people injured by drugs, like Xiaflex, and helped by Alternative Medicine. 

I believe a far more rational and safe approach to treating these two problems, and many others, is to first attempt more conservative treatment using a wide variety of simultaneous Alternative Medicine treatment methods.   Only after exhausting all possible conservative options would I remotely consider taking the calculated risk of a drug like Xiaflex.   The tone of your question suggests to me that you are not aware of, or even considering, the possible harm that can be done with a drug like Xiaflex.  

Many new drugs come on the market each year because of glowing reports and spectacular enthusiasm for the wonderful research results.  The new drug is highly advertised and heavily used for a while.  Then slowly and quietly new information comes out that bad things are happening to those who take this new wonder drug.  Even more quietly the drug is removed from the market a year or two later.  How many times have you heard that same story played out over and over?  High hopes based on questionable research, people hurt, drug withdrawal, many lawsuits. 

Why do we see so many TV commercials from lawyers who are trying to sue the pants off these drug companies?   The legal profession has created this large industry for itself because there are so many bad drugs on the market and so many people who are injured, that lawyers can profit from this misfortune.  What should that tell you?  The lawyers are not making this stuff up.  They are just taking great advantage of the huge opportunity they are given by bad drugs and injured people. 

Fact:  The U.S. is the heaviest user of drugs and surgery.  Fact: The U.S. is ranked about the 16th healthiest nation in the world, and we die at an earlier age, behind 15 other countries that take fewer drugs and use less surgery than we do.  If the use of drugs and surgery leads to health and long life, we should live the longest and be the healthiest country and we are not.  What does that tell you?

Sure, there are good drugs and not all drugs are bad.  But you must be extremely careful how you go about using them.  Xiaflex might help you, I cannot say one way or the other.  In my opinion, if you are going to use Xiaflex it should be the very last thing you do, not the first thing.  You should certainly talk to your doctor about your decision and educate yourself to the best level you can. How you approach the treatment of your problem is your decision.  TRH

Dupuytren Cause Could Be Related to Drugs

Prescriptions drugs indirectly related to Dupuytren cause

The cause of Dupuytren contracture remains unknown, but is logically most often attributed to trauma to the hand.  However, it is age, genetic predisposition and liver cirrhosis related to alcoholism that are more strongly associated with the causation of this problem.  While trauma (either small repeated injuries as with a bricklayer, or a large one-time injury as with a fall or crushing trauma), can be implicated in some cases, its relationship is not statistically significant.

Refuting the idea that trauma is a casual factor for Dupuytren hand and finger contracture are a few simple observations.  It has been frequently noted that the hand that actually develops the hand lump of Dupuytren is very often the side opposite the side of handedness; it is assumed that right handed workers would sustain more trauma to their right hand, yet these right handed people often develop a Dupuytren contracture on the opposite or left hand, and vice versa.    Also, it has been observed that people who have sustained significant past trauma to a hand will later develop a bump on palm of the hand on the opposite side to which significant trauma cannot be recalled.

In those who already have age, gender (male), genetic predisposition and liver disease in their history working against them, it would be wise for this group of people to pay close attention to drug intake that might potentially overwhelm the immune defense response to allow development of Dupuytren contracture.

While no single drug or drug family has been implicated in causing Dupuytren hand contracture, there is a potential for many drugs to initiate this problem via the indirect mechanism by causing liver disease and cirrhosis usually associated with alcoholism.

As a general guideline, this list is provided to demonstrate some of the many drugs that affect the liver to one degree or another.

Drugs that may cause acute dose-dependent liver damage

  • acetaminophen
  • salicylates (doses over 2 grams daily)

Drugs that may cause acute dose-independent liver damage

  • acebutolol
  • labetalol
  • quinine
  • indomethacin
  • phenylbutazone
  • allopurinol
  • isoniazid
  • phenytoin
  • lisinopril
  • atenolol
  • ketoconazole
    • piroxicam
      ·  carbamazepine
      ·  cimetidine
    • maprotiline
    • pyrazinamide
    • dantrolene
    • metoprolol
    • quinidine
      • diclofenac
        ·  probenecid
      • cimetidine
      • maprotiline
      • pyrazinamide
      • dantrolene
      • metoprolol
      • quinidine
        • diclofenac
          ·  penecillins
        • mianserin
          ·  phenelzine
        • tricyclic antidepressants
        • halothane
        • phenindione
        • valproic acid
        • ibuprofen
        • phenobarbital
          • verapamil
  • ethionamide

The bottom line concerning all these drugs is that every one of them has side-effects and ways of complicating the problem of someone who is already sick.  Drugs should be used with great reserve and discretion, and avoided if at all possible.

If you are man in a higher age, with a history of Dupuytren contracture in your family and you have a history of cirrhosis or heavy alcohol consumption, you would be wise to speak to your doctor if you are taking any of the above drugs because you could be stressing our liver and putting yourself at further risk of Dupuytren contracture.

Once Dupuytren contracture is present and someone learns that there is no known medical treatment available other than risky surgery, consider using Alternative Medicine as a Dupuytren contracture treatment option.  This is an option that the Dupuytren Contracture Institute has researched and developed since 2002, with considerable success.