Intralesional interferon-alpha-2b for the treatment of Peyronie's disease

Abstract

Peyronie's disease can best be described as a localized connective tissue disorder that primarily affects the tunica albuginea of the penis. The disease may be attributed to repetitive vascular trauma that initiates an inflammatory process and ultimately leads to the formation of a fibrous penile plaque. The plaque consists mainly of collagen and can significantly alter penile anatomy and function. Patients with Peyronie's disease will most often present with penile curvature, pain on erection, a palpable nodule most commonly located on the dorsal shaft of the penis, and erectile dysfunction. There is no definitive treatment for Peyronie's disease and the treating physician has many options. They may wait for spontaneous resolution of the plaque, choose medical therapy (which includes both oral and intralesional regimens), or opt for surgical management. The main purpose of this article is to discuss the advances in medical therapy for Peyronie's disease, in particular intralesional injection of interferon-alpha-2b (IFN-a-2b). Several studies have concluded that IFN-a-2b can be an effective modality of treatment and that many patients placed on a regimen of IFN-a-2b experienced a significant reduction in penile curvature, diminished pain with erection, and decreased size of the plaque. Further clinical studies are currently being undertaken to determine the precise quantity and frequency of administration of IFN-a-2b that is most effective with the least amount of side effects.

The management of Peyronie's disease

“…The use of intralesional interferon α2α in inflammatory PD is based on a good scientific rationale but early clinical use, although successful in some studies, has been prohibitive because of cost and the flu‐like side‐effects [54].…”

A review of the epidemiology and treatment of Peyronie's disease

“…IFN targets fibroblast proliferation involved in plaque formation. 36 , 37 IFN injections are typically performed, biweekly over a 6-week period. 37 IFN has been evaluated in one large randomized controlled trial and eight observational studies.…”

“… 38 IFN at higher doses than those studied has been linked with some severe side effects including a flu-like illness, anorexia, rash, hypotension, and possible cardiac arrhythmias. 36 The AUA recommended using this medication in appropriate settings. 25 …”

Systematic review of the epidemiology and therapy of Peyronie's disease

“…2 приведены все ви ды инъекций, которые были описаны для лечения БП. ИФН влияет на пролиферацию фибробластов, которые участвуют в формировании бляшки [36,37]. Инъекции ИФН, как правило, выполняются однократно в 2 нед в те чение 6 нед [37].…”

“…Наблюдалась тенденция (ста тистически недостоверная), что пациенты с большей кри визной имели лучший эффект [38]. ИФН при более высо ких дозах, чем были представлены в исследовании, был связан с некоторыми серьезными побочными эффектами, в том числе гриппоподобное состояние, потеря аппетита, сыпь, гипотония, аритмия [36]. АUА рекомендует исполь зовать этот препарат в соответствующих дозах [25].…”