The Efficacy of Medical Treatment of Peyronie's Disease: Potassium Para-Aminobenzoate Monotherapyvs.Combination Therapy with Tamoxifen, L-Carnitine, and Phosphodiesterase Type 5 Inhibitor

Abstract

PurposeThis study was designed to evaluate the efficacy of medical treatment of Peyronie's disease.Materials and MethodsA total of 109 patients with Peyronie's disease who had been treated from January 2011 to December 2014 were retrospectively reviewed in this study. Forty-four patients (Group 1) were treated with 12 mg of potassium para-aminobenzoate daily. Sixty-five patients (Group 2) were treated with combination therapy: tamoxifen (20 mg) and acetyl-L-carnitine (300 mg) twice daily in addition to a phosphodiesterase type 5 inhibitor. Ability to perform sexual intercourse, pain during erection, size of plaque, and penile curvature angle were assessed.ResultsIn Group 1, 30 of 44 patients (68.2%) discontinued treatment within 12 weeks, while 5 patients (7.7%) in Group 2 discontinued treatment. Pain during erection and plaque size were improved in both groups but showed no statistical difference due to the high dropout rate in Group 1. In both groups, penile curvature was improved, but demonstrated no statistical difference between the treatment groups. However, combination therapy demonstrated a better response rate in patients whose penile curvature angle was less than 30° (44.4% vs. 79.1%, p=0.048). The rate of successful sexual intercourse was significantly higher in Group 2 (42.8% vs. 78.3%, p=0.034). The number of patients who underwent surgical correction despite medical treatment was significantly higher in Group 1 (35.7% vs. 13.3%, p=0.048).ConclusionsEarly medical combination therapy in Peyronie's disease may present better results in patients whose curvature angle is less than 30°.

Antifibrotic Synergy Between Phosphodiesterase Type 5 Inhibitors and Selective Oestrogen Receptor Modulators in Peyronie's Disease Models

“…Previous clinical studies have shown mixed results using PDE5i and SERMs [33][34][35][36][37]. An open-label single-arm study with tamoxifen showed a positive effect [33], while a later placebo-controlled study showed no effect with tamoxifen [34].…”

“…However, the open-label study noted that tamoxifen showed some improvement in patients with early PD [33], while all the patients in the latter study were in the late phase of the disease [34]. Similarly, in studies with PDE5i, the results have been mixed [35][36][37]. This is not surprising since the drugs were tested on patients with established plaque-fibrotic tissue.…”

Does Transfer Capacitive Resistive Energy Has a Therapeutic Effect on Peyronie's Disease? Randomized, Single-Blind, Sham-Controlled Study on 96 Patients: Fast Pain Relief

“…The result on pain reduction is striking when compared to the sham group and with the historical results of steroids and ant-inflammatory drugs from the literature [3] .…”

“…Many oral therapies have been used for the treatment of PD, that is, vitamin E, potassium para-aminobenzoate, tamoxifen, colchicin, carnitine, and pentoxifylline [3] .…”

­­­­­­Recent advances in managing Peyronie’s disease

“…Park et al . report on Potaba versus combination therapy of tamoxifen, l -carnitine, and tadalafil 19 . Perhaps the most striking result was that two-thirds of the patients in the Potaba arm withdrew for varying reasons, although treatment side effects were cited as the largest single factor.…”