Experience in the use of collagenase clostridium histolyticum in the management of Peyronie’s disease: current data and future prospects

Abstract

Introduction: Peyronie's disease (PD) is a chronic wound-healing disorder characterized by formation of fibrous inelastic scarring of the tunica albuginea resulting in a variety of penile deformities. In most cases, PD is accompanied by a physical and psychological impact. Xiaflex ® is an injectable collagenase clostridium histolyticum (CCh) preparation consisting of a predetermined mixture of two distinct collagenases. Recently the US Food and Drug Administration (FDA) approved Xiaflex ® for the nonsurgical treatment of men with PD with curvature of 30° or more and tangible scar tissue plaque in their penis. Method: This article presents a comprehensive review of the updated information on the use of Xiaflex ® for the nonsurgical treatment of PD. Results: Mean improvements in penile curvature ranging from 29% to 34% and in bother domain scores have been reported. The majority of the reported adverse effects are mild or moderate and 79% resolve without intervention. Conclusion: The combined results of these trials have led to the FDA approval of CCh for the treatment of PD. However, the long-term effects and results need further investigation, with large follow-up series. Considering these results, future perspectives will probably result in the use of a combined or sequential therapy including CCh.

Collagenase Clostridium Histolyticum: A Review in Peyronie’s Disease

“…Results suggest that prior treatment with CCH does not limit a patient's subsequent surgical straightening treatment options [32]; however, further well-designed studies are needed to confirm these initial observations. Studies assessing the long-term effects of CCH therapy [2,31], its use in patients with hourglass deformity, ventral curvature, calcified plaque or plaque located proximal to the base of the penis [31] and identifying predictors of optimal treatment success in subgroups of PD patients [27] would also be helpful.…”

“…Peyronie's disease (PD) is a fibrotic disorder characterized by penile plaque formation in the tunica albuginea, resulting in a variety of deformities, such as curvature, shortening, narrowing and hinge defect [1][2][3]. PD has a major impact on patients' sexual and psychological function [4], with almost half of the patients having relationship problems and clinically meaningful depression and 81 % of patients having emotional problems [5,6].…”

Antifibrotic Synergy Between Phosphodiesterase Type 5 Inhibitors and Selective Oestrogen Receptor Modulators in Peyronie's Disease Models

“…The disease has been shown to be prevalent, especially as men get older [1], and affects quality of life, principally through pain during erection, erectile dysfunction, loss of penetrative ability during intercourse, and associated psychological stress [2,3]. Despite the progress in understanding the pathophysiology of PD, there is currently a lack of efficacious medical therapies for PD, with surgery or collagenase injections [4] being the main treatment options. Although the surgical outcomes following penile straightening are well documented, surgery is invasive, costly, and frequently detrimental to penile size and erectile function [5].…”

Role of collagenase clostridium histolyticum in Peyronie's disease

“…In the initial clinical trials, CCH was administered in doses reported in active biofactor units. The conversion factor for CCH is 10,000 active biofactor units equals 0.58 mg. 43 For convenience, all doses will be reported in milligrams.…”