Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
CONTEXT Conservative therapies for Peyronie 's disease ( PD ) aim to treat early-stage disease by improving clinical outcomes such as penile curvature , penile length erectile dysfunction , and pain .
OBJECTIVE To summarise the available evidence regarding injection and mechanical therapies for PD treatment .
Clinical safety and effectiveness of collagenase clostridium histolyticum injection in patients with Peyronie's disease: a phase 3 open-label study.
INTRODUCTION Collagenase clostridium histolyticum ( CCH ; Xiaflex , Auxilium Pharmaceuticals , Inc. , Chesterbrook , PA , USA ) is a Food and Drug Administration-approved , intralesional treatment for Peyronie 's disease ( PD ) . AIM The aim of this study was to assess the safety and effectiveness of CCH in the treatment of PD . METHODS This phase 3 , open-label study enrolled subjects who were CCH-naïve , were enrolled in a previous pharmacokinetic study , or had received placebo in an earlier phase 2 CCH study . Each treatment cycle included two intralesional injections of CCH 0.58 mg , approximately 24 - 72 hours apart , and plaque modeling 24 - 72 hours after the second injection of each cycle . The treatment cycle was repeated after 6 weeks for ≤4 treatment cycles . MAIN OUTCOME MEASURES The co- primary end points were the mean percent change in penile curvature deformity and the mean improvement in PD bother score ( range 0 - 16 ) from baseline to week 36 . RESULTS Of the 347 subjects treated with ≥1 injection , 238 had both a penile curvature measurement and a Peyronie 's Disease Question naire response at baseline and ≥1 subsequent time point . Mean baseline penile curvature deformity was 53.0 ° and mean PD symptom bother was 7.3 . Statistically significant mean improvements from baseline to week 36 were observed in both penile curvature deformity ( 34.4 % [ 95 % confidence interval { CI } , 31.2 % , 37.6 % ] ) and PD symptom bother score ( 3.3 [ 95 % CI , 2.8 , 3.7 ] ) . Most adverse events ( AEs ) were mild or moderate in severity and local to the penis . There were three serious treatment-related AEs , two penile hematomas and one corporal rupture ; all resolved with treatment . CONCLUSIONS Potentially clinical ly meaningful and statistically significant improvements in penile curvature deformity and PD symptom bother scores were observed with intralesional injection of CCH compared with baseline in men with PD . CCH was generally well tolerated , with AEs primarily transient and local to injection site . In conjunction with previous studies , the results of this open-label study support the use of CCH in the treatment of PD
Qualitative data from these studies suggest a clinical ly significant effect of CCH and IFNα-2b injection therapy to decrease penile curvature and conserve penile length .
Verapamil and HA performed well in single-arm or case-control studies .
Studies of penile traction and vacuum devices in patients with PD demonstrated some benefits in terms of curvature and penile length but only in small , underpowered , nonr and omised studies .
Studies of onabotulinum toxin A injections or thiocolchicine showed significant improvements in penile curvature , but only in studies of single-arm or case-control design .
CONCLUSIONS CCH and IFNα-2b injected into stable PD plaques can decrease penile curvature ; CCH can also improve penile length .
However , based on available data , strong conclusions can not be drawn for other treatments , including calcium channel blockers , HA , or mechanical therapies .
PATIENT SUMMARY Our systematic review of injection therapies provides evidence for improvements in penile curvature for patients with Peyronie 's disease .
No robust evidence is available to support the use of other local treatments including calcium channel blockers , hyaluronic acid , or mechanical therapies
CONTEXT Conservative therapies for Peyronie 's disease ( PD ) aim to treat early-stage disease by improving clinical outcomes such as penile curvature , penile length erectile dysfunction , and pain .
OBJECTIVE To summarise the available evidence regarding injection and mechanical therapies for PD treatment .