To study, in a multi-institutional setting, the efficacy/safety outcomes in acute phase Peyronie's Disease (PD) of multiple high-volume centers employing CCH to treat PD, which is defined as the abnormal formation of fibrous plaque(s) in the tunica albuginea of the penis. It is a chronic condition that afflicts 3% to 13% of the US male population. There is no current multi-institutional research on the efficacy and safety of collagenase Clostridium histolyticum (CCH) in the treatment of acute phase PD.
Retrospective data were collected for consecutive patients with PD who underwent treatment with CCH between April 2014 and March 2018 at five institutions. 918 patients were included. Patients with duration of PD no longer than 6 months at presentation qualified as being in the acute phase of PD. Main outcomes of interest include the change in curvature after receiving CCH therapy, and frequency of serious treatment-related adverse events. Successful improvement in curvature is defined as an at least 20% decrease in penile curvature from baseline after CCH therapy.
A total of 918 patients were included in the analysis, of which 134 (14.6%) qualified as acute phase PD (group 1) and the remaining 784 (85.4%) qualified as stable phase (group 2). Mean duration of PD was 4.44 ± 1.68 months for group 1, and 40.8 ± 61.2 months for group 2. There was no significant difference in final change in curvature between acute and stable phase of PD (13.5° vs. 15.6°, p=0.09). There was no statistically significant difference in frequency of treatment-related adverse events between the acute phase (16 patients, 11.9%) and the stable phase (77 patients, 9.8%) (p=0.44). In our multivariate analysis, only number of CCH cycles received was predictive of improvement of curvature.
This large multi-institutional analysis confirms that CCH therapy is as safe and efficacious in acute phase PD as it is in stable phase PD.
Urology. 2020 Aug 07 [Epub ahead of print]
Hoang Minh Tue Nguyen, Ayad Yousif, Amanda Chung, Ramón Virasoro, Ashley Tapscott, Matthew Ziegelmann, Landon Trost, Martin Gelbard, Wayne J G Hellstrom
Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA., Eastern Virginia Medical School, Department of Urology, Norfolk, VA, USA., Carolina Urology Partners, Huntersville, NC, USA., Mayo Clinic, Department of Urology, Rochester, MN, USA., University of California, Los Angeles, Department of Urology, Los Angeles, USA., Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA. Electronic address: .