Meta-analysis ranks medical therapies for Peyronie’s disease

  • Russo GI & al.
  • J Sex Med
  • 25 Jan 2019

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Collagenase Clostridium histolyticum (CCH) and interferon α-2b are the best intralesional therapies for correcting penile curvature (PC) caused by Peyronie’s disease (PD).
  • Hyaluronic acid has the greatest effect in restoring erectile function (EF).

Why this matters

  • “Urologists should discuss medical therapy with patients before surgical correction, as well as the target of improvement that they expect to obtain,” say researchers.

Study design

  • Researchers analyzed randomized controlled trials comparing ≥1 intralesional therapy with placebo or another drug for treating PD (8 trials; n=1050).
  • Outcome measures were mean changes in PC in degrees and EF as assessed with the International Index of Erectile Function (IIEF) questionnaire.
  • Funding: None.

Key results 

  • Mean PC treatment efficacy vs placebo (95% CIs):
    • CCH: −0.41 (−19.0 to 18.17);
    • interferon α-2b: −0.50 (−18.47 to 17.47);
    • verapamil: 1.88 (−14.56 to 18.32); and
    • hyaluronic acid: 6.25 (−13.56 to 6.06).
  • Mean EF treatment efficacy vs placebo (95% CIs):
    • hyaluronic acid: 1.78 (1.31-2.43);
    • verapamil: 1.16 (0.16-2.16);
    • CCH: −0.61 (−1.01 to −0.20); and
    • interferon α-2b: 0.04 (−0.39 to 0.48).

Limitations

  • The analysis did not include other PD outcomes (pain, plaque size, and patient satisfaction) because of a lack of homogeneity across trials.

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