{"id":12645,"date":"2025-07-08T10:50:46","date_gmt":"2025-07-08T14:50:46","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/collagenase-clostridium-histolyticum-cch\/"},"modified":"2026-10-06T15:38:20","modified_gmt":"2026-10-06T19:38:20","slug":"colagenase-de-clostridium-histolyticum-cch","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/colagenase-de-clostridium-histolyticum-cch\/","title":{"rendered":"Colagenase de Clostridium Histolyticum (CCH)"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[135],"glossary-product":[104,105],"class_list":["post-12645","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-peyronies-disease-treatments","glossary-product-infla10-pulse-ipp-series","glossary-product-rigi10-malleable-penile-prosthesis"],"acf":{"gt-definition":"<p>A colagenase de Clostridium histolyticum (CCH) \u00e9 uma prepara\u00e7\u00e3o enzim\u00e1tica derivada da bact\u00e9ria <em>Clostridium histolyticum<\/em>. \u00c9 composta por uma mistura de duas colagenases purificadas, AUX-I e AUX-II, que s\u00e3o proteinases que hidrolisam seletivamente o col\u00e1geno. \u00b9\u02d2\u00b2 Essas enzimas atuam sinergicamente para quebrar a estrutura em tripla h\u00e9lice do col\u00e1geno, levando \u00e0 lise dos dep\u00f3sitos de col\u00e1geno. \u00b3 A principal finalidade da CCH em urologia \u00e9 ser uma op\u00e7\u00e3o de tratamento n\u00e3o cir\u00fargico para a doen\u00e7a de Peyronie (DP), na qual atua sobre as placas colagenosas na t\u00fanica albug\u00ednea do p\u00eanis que causam curvatura e deformidade peniana, degradando-as. \u00b9\u02d2\u2074 Tamb\u00e9m \u00e9 utilizada no tratamento da contratura de Dupuytren, um dist\u00farbio fibroproliferativo semelhante que afeta a m\u00e3o. \u00b2 Al\u00e9m disso, uma formula\u00e7\u00e3o t\u00f3pica de colagenase \u00e9 utilizada para o desbridamento enzim\u00e1tico de \u00falceras d\u00e9rmicas cr\u00f4nicas e de tecidos com queimaduras graves, removendo o tecido necr\u00f3tico e promovendo a cicatriza\u00e7\u00e3o. \u2075 Uma forma injet\u00e1vel (Qwo) tamb\u00e9m foi aprovada para o tratamento da celulite moderada a grave em mulheres adultas, atuando sobre os septos fibr\u00f3ticos respons\u00e1veis pelo aspecto ondulado da pele, mas seu fabricante encerrou a produ\u00e7\u00e3o e a venda em 2022. \u2076<\/p>","gt-synonyms":"Clostridiopeptidase A, Clostridium histolyticum colagenase, Colagenase, Santyl, Xiaflex, Qwo, Colagenase clostridium histolyticum-aaes, CCH, AUX-I e AUX-II.\u00b2","gt-citation":"[1] Peak TC, Mitchell GC, Yafi FA, Hellstrom WJ. Role of collagenase clostridium histolyticum in Peyronie\u2019s disease. Biologics. 2015;9:107-116. doi:10.2147\/BTT.S65619\n\n[2] DrugBank. Collagenase clostridium histolyticum. DrugBank Online. Accessed May 15, 2025. https:\/\/go.drugbank.com\/drugs\/DB00048\n\n[3] Gelbard M, Goldstein I, Hellstrom WJ, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190(1):199-207. doi:10.1016\/j.juro.2013.01.087\n\n[4] Levine LA, Cuzin B, Mark S, Gelbard MK, Jones NA, Liu G, Kaufman GJ, Tursi JP, Ralph DJ. Clinical safety and effectiveness of collagenase clostridium histolyticum injection in patients with Peyronie's disease: a phase 3 open-label study. J Sex Med. 2015;12(1):248-258. doi:10.1111\/jsm.12731. PMID: 25388099.\n\n[5] MedlinePlus. Collagenase Clostridium Histolyticum Injection. MedlinePlus Drug Information. Accessed May 15, 2025. https:\/\/medlineplus.gov\/druginfo\/meds\/a612029.html\n\n[6] Endo International. QWO\u00ae (collagenase clostridium histolyticum-aaes) for injection, Prescribing Information. 2020. Available from: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2020\/761146s000lbl.pdf. Accessed May 15, 2025.\n\n[7] Gelbard M, Lipshultz LI, Tursi J, et al. Phase 2b study of the clinical efficacy and safety of collagenase Clostridium histolyticum in patients with Peyronie disease. J Urol. 2012;187(6):2268-2274. doi:10.1016\/j.juro.2012.01.032. PMID: 22503048.\n\n[8] Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie's disease: a prospective, single-center, non-placebo-controlled study. J Sex Med. 2008;5(1):180-187. doi:10.1111\/j.1743-6109.2007.00651.x\n\n[9] Goldstein I, Lipshultz LI, McLane M, et al. Long-Term Safety and Curvature Deformity Characterization in Patients Previously Treated with Collagenase clostridium Histolyticum for Peyronie's Disease. J Urol. 2020;203(6):1191-1197. doi:10.1097\/JU.0000000000000743. PMID: 31922462.\n\n[10] National Center for Biotechnology Information. PubChem Compound Summary for CID 16132697, Collagenase clostridium histolyticum. https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/Collagenase-clostridium-histolyticum. Accessed May 15, 2025.","gt-clinical-context":"<p>A colagenase de Clostridium histolyticum (CCH) \u00e9 utilizada clinicamente em condi\u00e7\u00f5es caracterizadas por deposi\u00e7\u00e3o excessiva ou patol\u00f3gica de col\u00e1geno. Sua principal aplica\u00e7\u00e3o em urologia (onde dispon\u00edvel; foi retirada do mercado europeu pelo fabricante) \u00e9 o tratamento da doen\u00e7a de Peyronie (DP) em homens adultos que apresentam placa palp\u00e1vel e deformidade de curvatura peniana, normalmente de pelo menos 30 graus no in\u00edcio da terapia.<sup>1<\/sup>\u02d2<sup>3<\/sup> A sele\u00e7\u00e3o de pacientes para o tratamento com CCH na DP envolve uma avalia\u00e7\u00e3o minuciosa, incluindo hist\u00f3ria cl\u00ednica, exame f\u00edsico para caracterizar a placa (tamanho, localiza\u00e7\u00e3o, consist\u00eancia) e avalia\u00e7\u00e3o da curvatura peniana, frequentemente com ere\u00e7\u00e3o induzida farmacologicamente e ultrassonografia com Doppler duplex.<sup>1<\/sup>\u02d2<sup>7<\/sup> Os candidatos ideais s\u00e3o aqueles com doen\u00e7a est\u00e1vel (normalmente h\u00e1 pelo menos 6-12 meses, sem piora da curvatura ou da dor por pelo menos 3-6 meses) e com uma placa claramente palp\u00e1vel e pass\u00edvel de inje\u00e7\u00e3o. Em geral, n\u00e3o \u00e9 recomendada para pacientes com placas ventrais, deformidades em ampulheta sem placa definida ou placas calcificadas, que provavelmente n\u00e3o responder\u00e3o \u00e0 digest\u00e3o enzim\u00e1tica.<sup>1<\/sup><\/p>\n<p>O procedimento envolve inje\u00e7\u00f5es intralesionais de CCH diretamente na placa de Peyronie. Um curso de tratamento normalmente consiste em at\u00e9 quatro ciclos de tratamento. Cada ciclo envolve dois procedimentos de inje\u00e7\u00e3o administrados com intervalo de 1 a 3 dias, e os ciclos s\u00e3o repetidos aproximadamente a cada 6 semanas.<sup>3<\/sup>\u02d2<sup>4<\/sup> Entre 24 e 72 horas ap\u00f3s a segunda inje\u00e7\u00e3o de cada ciclo, o profissional de sa\u00fade realiza um procedimento de modelagem peniana (alongamento e retifica\u00e7\u00e3o suaves do p\u00eanis), e os pacientes tamb\u00e9m s\u00e3o orientados sobre como realizar diariamente exerc\u00edcios de modelagem peniana em casa durante todo o tratamento.<sup>3<\/sup> Essa combina\u00e7\u00e3o de ruptura enzim\u00e1tica da placa e modelagem mec\u00e2nica visa reduzir a curvatura peniana e melhorar a deformidade.<\/p>\n<p>Os resultados esperados incluem uma redu\u00e7\u00e3o estatisticamente significativa da deformidade de curvatura peniana e uma diminui\u00e7\u00e3o do inc\u00f4modo relatado pelos pacientes em decorr\u00eancia dos sintomas da DP.<sup>1<\/sup>\u02d2<sup>3<\/sup> Ensaios cl\u00ednicos (por exemplo, IMPRESS I e II) demonstraram melhoras m\u00e9dias na curvatura peniana de aproximadamente 34% (cerca de 17 graus), em compara\u00e7\u00e3o com cerca de 18% (cerca de 9 graus) nos grupos placebo.<sup>3<\/sup> Os pacientes tamb\u00e9m podem apresentar melhora na consist\u00eancia da placa. O in\u00edcio da melhora pode ser observado j\u00e1 na 6\u00aa semana de tratamento e pode continuar ao longo do curso de tratamento e do per\u00edodo de acompanhamento.<sup>3<\/sup>\u02d2<sup>9<\/sup> A recupera\u00e7\u00e3o de cada procedimento de inje\u00e7\u00e3o normalmente envolve rea\u00e7\u00f5es localizadas, como equimose peniana, incha\u00e7o, dor e hematoma, que geralmente s\u00e3o transit\u00f3rias e se resolvem em dias a semanas.<sup>1<\/sup>\u02d2<sup>3<\/sup> Eventos adversos graves, embora raros, podem incluir ruptura dos corpos cavernosos (fratura peniana) ou outras les\u00f5es penianas graves, o que exige sele\u00e7\u00e3o cuidadosa dos pacientes, t\u00e9cnica de inje\u00e7\u00e3o adequada e orienta\u00e7\u00f5es p\u00f3s-procedimento, incluindo evitar atividade sexual por um per\u00edodo ap\u00f3s o tratamento.<sup>1<\/sup><\/p>\n<p>Al\u00e9m da doen\u00e7a de Peyronie, a CCH (Xiaflex) tamb\u00e9m \u00e9 aprovada em alguns pa\u00edses para a contratura de Dupuytren em adultos com cord\u00e3o palp\u00e1vel, situa\u00e7\u00e3o em que \u00e9 injetada no cord\u00e3o de col\u00e1geno para facilitar sua ruptura e melhorar a extens\u00e3o dos dedos.<sup>2<\/sup> Uma formula\u00e7\u00e3o t\u00f3pica (por exemplo, Santyl) \u00e9 utilizada para o desbridamento de \u00falceras d\u00e9rmicas cr\u00f4nicas (como \u00falceras por press\u00e3o, \u00falceras diab\u00e9ticas e \u00falceras por estase venosa) e de \u00e1reas com queimaduras graves, removendo enzimaticamente o tecido necr\u00f3tico para promover a cicatriza\u00e7\u00e3o.<sup>5<\/sup> Uma formula\u00e7\u00e3o injet\u00e1vel (Qwo) tamb\u00e9m foi aprovada para o tratamento da celulite moderada a grave nas n\u00e1degas de mulheres adultas, atuando sobre os septos fibrosos que causam as depress\u00f5es na pele, mas sua produ\u00e7\u00e3o e venda foram descontinuadas pelo fabricante em 2022.<sup>6<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":104},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Colagenase (CCH \/ Xiaflex): Tratamento da Doen\u00e7a de Peyronie | Rigicon<\/title>\n<meta name=\"description\" content=\"Saiba sobre a colagenase de Clostridium histolyticum (CCH\/Xiaflex) para doen\u00e7a de Peyronie. 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