Evolving therapies for Peyronie’s disease: how can we work towards new drugs?

Abstract

Peyronie's disease (PD) is an idiopathic chronic fibrotic disease that causes a penile curvature (PC), subsequent erectile dysfunction (ED) and impaired sexual intercourse in patients. As of yet, there are no reliable non-surgical treatment options available. Intralesional injection with collagenase Clostridum Histolyticum has been FDA approved since 2013, but post-approval studies have not been unanimously positive. Moreover, it renders a curvature improvement of only 30% on average, usually still requiring surgical intervention to remedy PC. Therefore, there is a need for drugs which could prevent surgery altogether. Development of new drugs can either be through a target-based or phenotypic assay-based approach. The current in vivo model for PD is dependent on treatment of primary PD-derived fibroblasts with transforming growth factor-β1. Moreover, despite the existence of a genetic in vivo PD model, it does not allow for drug screening or testing. While some advances have been made in the past few years, new in vivo and in vivo systems and well-designed studies are urgently needed for the non-surgical treatment of PD.

Molecular Mechanisms and Current Pharmacotherapy of Peyronie’s Disease: A Review

“…PD is divided into the acute phase, characterized by painful erections and a worsening penile curvature that is contraindicated to surgery, which occurs over 12–24 months, and the chronic phase, characterized by stable malformation and fibrotic plaque ( Garaffa et al, 2013 ; Milenkovic et al, 2020 ). Meanwhile, there has been no association of PD with penile trauma reported in previous studies, indicating that not only traumatic factors but some unknown elements may have played a role in the development of PD ( Zargooshi, 2004 ; Gabrielsen, 2020 ).…”

Identifying hub genes, key pathways and key immune-related genes in Peyronie’s disease by integrated bioinformatic analysis

“…In addition to reduced elasticity in TA, PD also results in penile deformity and intense pain, which significantly impair intercourse performance and mental health ( Krakhotkin et al, 2020 ). Furthermore, PD leads to many complications that may remarkably reduce the quality of life of males ( Milenkovic et al, 2020 ). Due to the lack of understanding of the pathology, there is currently no conservative or medical treatment for PD ( Pyrgidis et al, 2021 ).…”