The Impact of Intralesional Interferon α–2b Injection Therapy on Penile Hemodynamics in Men with Peyronie’s Disease

Abstract

Introduction Penile duplex Doppler ultrasound (PDDU) is currently the preferred method for the functional evaluation of penile hemodynamics. PDDU may be used to monitor objectively changes in penile vascular parameters in men who undergo treatment for Peyronie’s disease (PD), including intralesional interferon alpha–2b (IFN α–2b). Aim To investigate the impact of intralesional IFN α–2b therapy for PD on penile hemodynamics by using PDDU and to assess the objective role of PDDU in monitoring treatment outcomes. Materials and Methods Thirty–nine patients (20 in the placebo and 19 in the IFN α–2b treatment arm) were enrolled in this prospective, placebo–controlled, parallel study. Patients received either 10 mL saline or 5 × 106 units of IFN α–2b intralesional injections every other week for a total of six injections. Patients in each group were evaluated at baseline and after completion of treatment regarding changes in penile hemodynamic parameters, penile curvature, plaque size and density, pain on erection, and erectile function. Specific published criteria were used for PDDU measurements. Outcomes were statistically compared between each group by using Mann–Whitney U and chi–square tests. Results The mean age of the patients and the duration of PD were similar in both groups. The improvement in penile blood flow was significantly greater in IFN α–2b–treated patients than those in the placebo group. The number with the nonvascular classification increased significantly in the IFN α–2b arm from 31.5% to 57.8%. Additionally, improvements in penile curvature, plaque size and density, and pain on erection were better in the IFN α–2b group compared with the control. No significant improvement was observed in the erectile function domain in either group. Conclusion This study reveals that intralesional IFN α–2b injections have a significant benefit on penile hemodynamic parameters. Moreover, intralesional IFN α–2b is an effective, minimally invasive treatment for PD, and PDDU is a useful adjunct to monitor objectively changes in penile vascular parameters.

Outcomes of Intralesional Interferon-α2B for the Treatment of Peyronie Disease

“…Further analysis of a subgroup of patients who underwent penile U/S before and after ILI IFN revealed significant improvements in PSV and RI after IFN, which were not seen in the placebo group. 12 Findings also showed a decrease in the number of patients classified with borderline AI and an increase in those assigned to nonvascular status.…”

“…11,12 Determination of candidacy for ILI therapy was based on clinical and imaging factors. Patients with greater than 90-degree curvature, erectile dysfunction refractory to PDE5i, or multiple, complex or multiplanar curvature were not routinely recommended for ILI therapy.…”

Local therapy for Peyronie’s disease

“…Kendirci et al [ 27 ] completed a prospective, randomized, placebo-controlled trial with 39 patients: 20 men (mean age, 54 years) in the saline control group and 19 men (mean age, 56 years) in the IFN treatment group. They found signifi cant improvement in the IFN group with regard to penile curvature, plaque size, and vascular fl ow parameters (peak systolic velocity and resistive index).…”

“…They found signifi cant improvement in the IFN group with regard to penile curvature, plaque size, and vascular fl ow parameters (peak systolic velocity and resistive index). Patients received either 10 mL of saline or 5 × 10 6 U of IFN α -2b every other week for a period of 6 weeks [ 27 ].…”

Nonsurgical treatment options in Peyronie’s Disease: 2016 update

“…[27] One of the randomized-controlled trials (RCTs) evaluated the efficacy of intralesional IFN-α2β compared to placebo. [25] In this trial, the IFN group exhibited significant improvements in penile curvature, plaque size, and pain.…”