In November 2015, Endo exercised an early opt-in for CCH to include two new potential indications, lateral hip fat and plantar fibromatosis.

Lateral hip fat is similar in prevalence to cellulite and is common among women particularly as they age. It is often very difficult to improve its appearance through diet and exercise alone. In some cases, cyrolipolysis and liposuction are performed to remove the unsightly fat deposits.

Plantar fibromatosis is characterized by pain and disability caused by the thickening of the feet's deep connective tissue, a result of nodule formation along tendons of the foot. Current treatments include orthotics and anti-inflammatory drugs in the early stages of the disease, steroid injections and surgery in advanced cases.

Endo has also discussed the potential expansion into currently un-licensed indications including:

  • Capsular Contracture of the Breast: Post-surgical complication that can deform the breast and cause pain
    • ~15% of breast augmentation/ reconstructive surgery patients
  • Hypertrophic Scars & Keloids: Scars that form on the skin at the site of injury 
    • ~600,000 scar and ~400,000 keloid patients
  • Dercum's Disease: Obesity and overly sensitive painful adipose tissue 
    • Extremely rare condition
  • Knee Arthrofibrosis: Adhesions that form post-implant that may affect range of motion
    • ~100,000 patients per year in U.S.
  • Urethral Strictures: Narrowing of the urethra that may affect urine flow
    • 1% male population.


BioSpecifics is focused on the development of XIAFLEX and CCH for the treatment of serious medical conditions. The potential advantages of XIAFLEX injections vs. major surgery for many conditions is exponential. An injection of Xiaflex® takes about 5-10 minutes with no sedation and little to no recovery time.