A snapshot of intralesional verapamil injection in the treatment of Peyronie's disease today

Sadagopan, Ananthan

doi:10.1111/and.13388

Cited by 7 publications

(11 citation statements)

References 27 publications

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“…The remaining 42 articles were selected as eligible for the present review. Tables 1 [21][22][23][24][25][26][27][28] and 2 [29][30][31][32][33][34][35] summarise the highest impact and most clinically relevant studies to our research topicTables 2.…”

Section: Resultsmentioning

confidence: 99%

“…In a subsequent, and more reputable study, he showed verapamil injection reduced pain in 97% of patients, improved sexual function in 72%, and lessened the degree of curvature and deformity in 54% and 86%, respectively [ 22 ]. But other studies have shown IL verapamil to improve sexual function while not having much effect on the size of fibrous plaque [ 23 ]. It is for these mixed results and a lack of large-scale placebo-controlled studies that the United States Food and Drug Administration (FDA) has not formally approved verapamil for the treatment of PD.…”

Section: Therapiesmentioning

confidence: 99%

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Peyronie’s disease – outcomes of collagenaseclostridium histolyticuminjection: A systematic review

Mefford

Raheem

Yafi

et al. 2021

Arab Journal of Urology

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Objective: To review recent literature pertaining to collagenase clostridium histolyticum (CCh) and other intralesional (IL) therapies for the treatment of Peyronie's disease (PD). Methods: A systematic search of literature was performed using MEDLINE and PubMed.'Peyronie's Disease Clostridium Histolyticum', 'Peyronie's Disease Intralesional', 'Peyronie'sDisease Causes', and 'Atypical Peyronie's Disease' were used as query entries. Inclusion criteriarequired English text from 1980 onwards and have a full text available. Records were reviewed for study power, accuracy, and relevance to our research topic. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Results: Recent literature supports the notion that CCh is the most effective IL treatment forpatients with typical and atypical PD. The capstone CCh study was the IMPRESS trial thatshowed a 34% reduction in curvature with a mean (SD) -17.0 (14.8)° reduction with IL CCh,while men in the placebo saw an average 18.2% decrease in penile bend with a mean (SD) -9.3 (13.6)° per person (P < 0.001). A shortened protocol for IL CCh treatment offered a 31.4% reduction in curvature, while decreasing cost and office visits, potentially increasing patientcompliance. Lastly, literature shows CCh is used most in atypical cases, with ~64.8% of patients being treated with CCh, probably because of the high efficacy and safetyprofile that it offers. Serious complications associated with CCh include urethralinjury, corporal rupture, and penile fracture. Conclusion:Since the approval of CCh by the United States Food and Drug Administration in2013, it has been a staple in the treatment of PD, and here we report the continuedsuperiority of this therapy. CCh is an effective, minimally invasive option in most PDpopulations; however, recent changes have made CCh unavailable for commercial use outside the United States, impacting many patients who have previously benefited.

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Section: Resultsmentioning

confidence: 99%

Section: Therapiesmentioning

confidence: 99%

Peyronie’s disease – outcomes of collagenaseclostridium histolyticuminjection: A systematic review

Mefford

Raheem

Yafi

et al. 2021

Arab Journal of Urology

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“…While most of the published PD studies reported positive outcomes, many studies lack standardized outcome measures to allow for direct comparison [ 11 ]. Studies have shown that the volume and duration of the ILV protocol could play a role, too [ 1 2 3 4 ]. While the 6 courses of verapamil given in our study protocol were similar to Levine’s original study [ 4 ], the volume of injection was different (10 mL in Levine’s vs. 4 mL in our study).…”

Section: Discussionmentioning

confidence: 99%

“…The systematic review of various intralesional plaque injectable agents have highlighted mixed clinical outcomes, and most of these agents are used as an off-label indication apart from collagenase Clostridium histolyticum (CCH) [ 1 3 ]. Intralesional verapamil (ILV) injection has been around for more than 3 decades and is shown to improve penile curvature and plaque volume [ 1 2 4 ]. The publication of 2 large-scale phase III clinical trials, Investigation for Maximal Peyronie’s Reduction Efficacy and Safety Studies (IMPRESS) I and II [ 5 ], has demonstrated that CCH significantly reduces penile curvature and plaque volume, and improves PD-associated symptom bother scores.…”

Section: Introductionmentioning

confidence: 99%

Intralesional collagenase Clostridium histolyticum vs. verapamil injections in males with Peyronie’s Disease: A prospective, matched-pair, non-blinded, randomised clinical study comparing clinical outcomes and patient satisfaction rates

Chung

Wang²

2022

Investig Clin Urol

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Purpose To compare clinical outcomes and patient satisfaction rates between intralesional verapamil (ILV) and collagenase Clostridium histolyticum (CCH) injections in males with Peyronie’s disease (PD). Materials and Methods Following ethics approval, PD patients were prospectively enrolled in this open-label non-blinded study. Patients were randomised to receive ILV or CCH injections with penile remodelling every fortnightly for 6 courses. Patient demographics, change in penile curvature, International Index of Erectile Function-15 and Peyronie’s Disease Questionnaire (PDQ) scores as well as overall patient satisfaction and Patient Global Impression of Improvement (PGI-I) scores were recorded at pre-treatment and 6-, 12- and 24-month post-treatment. Results A total of 50 males were recruited and divided into ILV (n=25) and CCH (n=25) groups. The mean changes in penile curvature were -16.8 (standard deviation [SD] 7.65) degrees in ILV and -28.2 (SD 11.5) degrees in CCH groups (p<0.01). Patients in the CCH group scored better than the ILV group on the PDQ psychosexual symptoms (-2.14 vs. -2.9; p<0.01) and symptom bother score (-3.88 vs. -4.16; p=0.08). Minor treatment-related adverse events were more common in the CCH group. The overall satisfaction rate on a 5-point scale was 4.1 in ILV and 4.5 in CCH groups, and there was no statistically significant difference in the PGI-I scores between the 2 groups (p=0.14). Conclusions CCH therapy is more effective than ILV to treat a carefully selected group of males with PD, with a reasonable safety profile and a higher high level of patient satisfaction rate in the short term.

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“…In a meta-analysis of seven different studies, intralesional injection of Verapamil significantly improved sexual function (p <0.0005) and penile curvature (p <0.005) in patients. There is an imprecise but significant reduction in pain after the treatment, but less effect on plaque size (p> .05) (65). In a prospective, single-blind, randomized study, the use of Verapamil in Peyronie's disease showed improvement in penile curvature and reduction in plaque size (66).…”

Section: Evidencementioning

confidence: 99%

Non-Surgical Treatment Options for Peyronie s Disease

ÇINAR¹,

Sarı²,

ALKAN³

et al. 2022

acmr

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Peyronie's disease, which occurs with the formation of a fibrous plaque in the tunica albuginea; is a disease that causes some physical problems such as bending and shortening of the penis. There are surgical treatment methods of this disease as well as non-surgical treatment methods. Non-surgical treatment methods, which are grouped under six headings: oral treatments, topical treatments, traction and vacuum treatments, shock wave therapy, intraplate injection treatments, and experimental treatments, can be preferred in cases where the symptoms are not very advanced because they provide advantages in terms of ease of application, accessibility, and cost. Although the only non-surgical treatment method approved by the FDA (U.S. Food and Drug Administration) yet is clostridium collagenase histolikum, which is used in intraplaque injection, studies have shown that other methods also reduce curvature, pain, and plaque volume.

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A snapshot of intralesional verapamil injection in the treatment of Peyronie's disease today

Cited by 7 publications

References 27 publications

Peyronie’s disease – outcomes of collagenaseclostridium histolyticuminjection: A systematic review

Peyronie’s disease – outcomes of collagenaseclostridium histolyticuminjection: A systematic review

Intralesional collagenase Clostridium histolyticum vs. verapamil injections in males with Peyronie’s Disease: A prospective, matched-pair, non-blinded, randomised clinical study comparing clinical outcomes and patient satisfaction rates

Non-Surgical Treatment Options for Peyronie s Disease

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