Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Hu, Ming‐yi; Sigalos, John T.; Walker, Dyvon; Li, Michelle K.; Yoffe, Dar A.; Modiri, Neilufar; Gaither, Thomas W.; Santamaria, Alvaro; Regets, K.; Jiang, Tommy; Mills, Jesse N.

doi:10.21037/tau-22-188

Cited by 3 publications

(8 citation statements)

References 38 publications

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“…27 A recent study from 2022 included 40 patients with hourglass deformity. 23 This study does not report on improvement in girth, indentation, or hourglass deformity and found no significant difference of curvature improvement after CCH therapy in patients with or without hourglass deformity (21.5% vs 15.3%, respectively, p=0.23). 23 Additional studies including patients with unilateral indentation or hourglass deformity do measure penile curvature as an endpoint, but most fail to report improvements in indentation deformities.…”

Section: Use Of Intralesional Injection Of Cch In Girth Loss Deformit...contrasting

confidence: 57%

Section: Introductioncontrasting

confidence: 57%

“… 29 Hu et al compared efficacy of CCH in acute versus chronic phase PD patients found that baseline curvature was an effect modifier on the success of CCH treatment. 23 This study noted that for every 1° of curvature, there was a 0.38% increase in penile curvature improvement after treatment (p= 0.002). Although these studies did not include patients with curvature greater than 90°, their conclusions suggest that further investigation is warranted for patients with more severe curvature.…”

Section: Introductionmentioning

confidence: 75%

“…When using patients fitting either definition of acute phase PD, 76 patients were included and showed a post-treatment improvement in overall curvature by 7.3° (16.5%) compared to 8.1° (16.3%) in all chronic phase PD patients (p= 0.96). 23 There was no statistically significant difference in the number of treatment related side effects between acute and chronic phase PD patients.…”

Section: Introductionmentioning

confidence: 78%

“…22 Given that the definition "acute phase" varies within the literature, a retrospective study from 2022 was the first to conduct separate analyses on patients based on two options for the definition of acute phase PD. 23 Definition 1 included 65 patients with symptom duration and changes in penile morphology occurring for ≤6 months; definition 2 included 37 patients with penile pain for a duration ≤12 months -some patients fit both definitions. There was no difference in initial curvature of patients regardless of the definition used for patients with acute phase PD.…”

Section: Use Of Intralesional Chh In Acute Phase Diseasementioning

confidence: 99%

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Expanded Utilization of Intralesional Therapies for Treatment of Peyronie’s Disease

Khooblall¹,

Bole²,

Lundy³

et al. 2023

RRU

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Purpose In this narrative review we explore additional indications for which intralesional collagenase Clostridium histolyticum (CCH) injection therapy may be used, in addition to those utilized in the IMPRESS trials. The goal is to provide updated assessment of available intralesional therapies and justify whether to expand clinical indications based on advancements over the last decade. Results Patients receiving CCH in the acute phase of PD have shown significant improvement in penile curvature - which may be even more significant than reported due to progressive curvature over the longitudinal course of injection therapy. Across studies, patients with ventral plaques achieved the greatest curvature improvement (~30°) compared to PD patients with dorsal or lateral plaques. Patients with curvature > 90° have been minimally documented. However, the concept of patients with higher degree of curvature achieving more significant degrees of improvement prevails across studies. Studies including PD patients with volume loss deformities or indentation(s) focus on curvature improvement and do not gauge improvement in these girth loss or indentation features specifically. PD patients with calcification may benefit from CCH, however, critical analysis of included study designs and results compared to placebo do not lend for strong support of CCH in PD at this time. Conclusion Based on the most recent research, the use of CCH in the acute phase of PD and patients with ventral penile plaques may be effective and safe. The limited available research on the efficacy of CCH on calcified plaque(s) and curvature greater than 90° is promising, however, more research is needed to ensure safety and success in this patient cohort. Finally, the current literature continues to show the use of CCH is not effective in PD patients with volume loss, indentation, or hourglass deformity. When expanding the use of CCH to patients not originally included in the IMPRESS trials, providers must prioritize minimizing chances of potential injury to urethral tissue. Finally, further investigation is required to determine whether CCH has utility for curvature greater than 90° or calcified plaques, although the limited available literature is promising.

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Section: Use Of Intralesional Injection Of Cch In Girth Loss Deformit...contrasting

confidence: 57%

Section: Introductioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 78%

Section: Use Of Intralesional Chh In Acute Phase Diseasementioning

confidence: 99%

See 3 more Smart Citations

Expanded Utilization of Intralesional Therapies for Treatment of Peyronie’s Disease

Khooblall¹,

Bole²,

Lundy³

et al. 2023

RRU

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Clinical and psychological effects post intralesional management with Collagenase Clostridium histolyticum in Peyronie's disease. Bibliographic review

Núñez

Rosero

2023

Salud, Ciencia y Tecnología

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Introducción: La enfermedad de Peyronie (EP) es un trastorno inflamatorio y fibrótico que afecta la túnica albugínea del pene que obedece a un enfoque multifactorial. Se caracteriza por la formación de una placa de tejido fibroso que produce una deformación angular en el pene que resulta en disfunción eréctil y problemas psicosexuales hacia el paciente. En el estudio de su tratamiento, la terapia intralesional fue una opción durante mucho tiempo sin resultados contundentes hasta la implementación de la colagenasa de clostridium histolyticum (CCH). Objetivo: Describir los resultados clínicos y psicológicos obtenidos de la intervención intralesional con colagenasa de clostridium histolyticum en el tratamiento de la EP. Métodos: Realizar una búsqueda bibliográfica de información actualizada en la base de datos de Pubmed bajo términos como enfermedad de Peyronie, fibromatosis peneana, colagenasa clostridium histolyticum. Resultados: Se obtuvieron 15 investigaciones desde el 2018 al 2023, con un total de 2.844 pacientes, en todos los estudios se reportaron mejorías en la corrección peneana, en 9 estudios reportaron resultados satisfactorios en IIEF-15 y PDQ, al igual que los resultados se vieron influidos por las características individuales, así como la modificación del protocolo terapéutico o agregación de terapias adyuvantes. Conclusiones: La terapia intralesional con CCH ha demostrado ser eficaz con y sin el uso de terapias concomitantes en la corrección de la curvatura peneana y disminución de los síntomas psicosexuales en la EP desde el primer ciclo terapéutico al igual que en casos atípicos, etapa aguda y en pacientes que reportaron calcificación.

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Acute Phase Peyronie’s Disease: Where Do We Stand?

Douroumis,

Kotrotsios,

Katsikatsos

et al. 2024

Cureus

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Peyronie’s disease (PD) is a common benign condition characterized by superficial fibrosis and scar formation at the tunica albuginea of the penis, eventually leading to penile curvature. It is believed that penile micro-traumas during intercourse and subsequent activation of inflammatory processes constitute the pathogenetic basis of the disease. Routinely, PD is divided into acute and chronic phases, with pain during erection or flaccid state being the hallmark of the former. Surgical intervention should be avoided during the acute phase, as the risk of recurrence or progression of penile deformity during this stage might affect the optimal outcomes of the procedure. During this stage, many conservative treatment options have been suggested, including oral, topical, and intralesional therapies, extracorporeal shock wave therapy (ESWT), and penile traction therapy (PTT). Currently, the optimal treatment consists of a combined treatment strategy with phosphodiesterase type 5 inhibitors (PDE5Is), ESWT for pain management, PTT, and intralesional therapies. Large, well-designed randomized controlled trials (RCTs) are necessary to further elucidate the most efficient treatment option for acute phase PD.

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Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Cited by 3 publications

References 38 publications

Expanded Utilization of Intralesional Therapies for Treatment of Peyronie’s Disease

Expanded Utilization of Intralesional Therapies for Treatment of Peyronie’s Disease

Clinical and psychological effects post intralesional management with Collagenase Clostridium histolyticum in Peyronie's disease. Bibliographic review

Acute Phase Peyronie’s Disease: Where Do We Stand?

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