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Pharmacological Management of Peyronie's Disease.
Drugs. 2007; 67(4):527-45.D

Abstract

Peyronie's disease is a localised, fibrosing condition of the penis that occurs in up to 9% of men. Although its aetiology has not been elucidated, Peyronie's disease probably results from the presence of a predisposing genetic susceptibility combined with an inciting event, most probably trauma. Following appropriate clinical evaluation, initial treatment consists of a trial of oral and/or intralesional pharmacotherapy. Oral therapies most commonly employed include para-aminobenzoate (Potaba) and tocopherol (vitamin E), with colchicine, tamoxifen, propoleum and acetyl-L-carnitine being used less frequently. Placebo-controlled studies examining these agents have failed to show a consistent beneficial effect on Peyronie's disease, with the exception of para-aminobenzoate, which may decrease plaque size and curvature, and acetyl-L-carnitine, which may reduce erectile pain and inhibit disease progression. Intralesional injection therapy for Peyronie's disease is commonly used as a first-line therapy along with oral medications. The current standard of care involves injection with interferon-alpha-2a or -2b, verapamil or collagenase over 2-week intervals for a period of 5-6 months. Interferon-alpha-2b, in particular, has been documented in a large, multicentre, placebo-controlled study to be significantly more effective than placebo in decreasing penile curvature, plaque size, penile pain and plaque density. However, interferon treatment is also associated with significant adverse effects, including fever and other flu-like symptoms. Other available therapies that have not consistently shown efficacy in placebo-controlled studies include corticosteroids and orgotein. Surgery is considered in patients with Peyronie's disease who have not responded to a trial of conservative medical therapy for 1 year and who are precluded from sexual intercourse. Procedures commonly performed include the Nesbit procedure (or variations of the Nesbit), penile plaque incision/excision with or without grafting, and implantation of a penile prosthesis. Further basic scientific research in Peyronie's disease is likely to identify additional targets for future pharmacotherapy.

Authors+Show Affiliations

Department of Urology, Tulane Health Sciences Center, New Orleans, Louisiana 70112, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17352513

Citation

Trost, Landon W., et al. "Pharmacological Management of Peyronie's Disease." Drugs, vol. 67, no. 4, 2007, pp. 527-45.
Trost LW, Gur S, Hellstrom WJ. Pharmacological Management of Peyronie's Disease. Drugs. 2007;67(4):527-45.
Trost, L. W., Gur, S., & Hellstrom, W. J. (2007). Pharmacological Management of Peyronie's Disease. Drugs, 67(4), 527-45.
Trost LW, Gur S, Hellstrom WJ. Pharmacological Management of Peyronie's Disease. Drugs. 2007;67(4):527-45. PubMed PMID: 17352513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacological Management of Peyronie's Disease. AU - Trost,Landon W, AU - Gur,Serap, AU - Hellstrom,Wayne J G, PY - 2007/3/14/pubmed PY - 2007/8/1/medline PY - 2007/3/14/entrez SP - 527 EP - 45 JF - Drugs JO - Drugs VL - 67 IS - 4 N2 - Peyronie's disease is a localised, fibrosing condition of the penis that occurs in up to 9% of men. Although its aetiology has not been elucidated, Peyronie's disease probably results from the presence of a predisposing genetic susceptibility combined with an inciting event, most probably trauma. Following appropriate clinical evaluation, initial treatment consists of a trial of oral and/or intralesional pharmacotherapy. Oral therapies most commonly employed include para-aminobenzoate (Potaba) and tocopherol (vitamin E), with colchicine, tamoxifen, propoleum and acetyl-L-carnitine being used less frequently. Placebo-controlled studies examining these agents have failed to show a consistent beneficial effect on Peyronie's disease, with the exception of para-aminobenzoate, which may decrease plaque size and curvature, and acetyl-L-carnitine, which may reduce erectile pain and inhibit disease progression. Intralesional injection therapy for Peyronie's disease is commonly used as a first-line therapy along with oral medications. The current standard of care involves injection with interferon-alpha-2a or -2b, verapamil or collagenase over 2-week intervals for a period of 5-6 months. Interferon-alpha-2b, in particular, has been documented in a large, multicentre, placebo-controlled study to be significantly more effective than placebo in decreasing penile curvature, plaque size, penile pain and plaque density. However, interferon treatment is also associated with significant adverse effects, including fever and other flu-like symptoms. Other available therapies that have not consistently shown efficacy in placebo-controlled studies include corticosteroids and orgotein. Surgery is considered in patients with Peyronie's disease who have not responded to a trial of conservative medical therapy for 1 year and who are precluded from sexual intercourse. Procedures commonly performed include the Nesbit procedure (or variations of the Nesbit), penile plaque incision/excision with or without grafting, and implantation of a penile prosthesis. Further basic scientific research in Peyronie's disease is likely to identify additional targets for future pharmacotherapy. SN - 0012-6667 UR - https://wwww.unboundmedicine.com/medline/citation/17352513/Pharmacological_Management_of_Peyronie's_Disease_ L2 - https://dx.doi.org/10.2165/00003495-200767040-00004 DB - PRIME DP - Unbound Medicine ER -