title: Combined intralesional interferon alpha 2B and oral vitamin E in the treatment of Peyronie's disease.
abstract: It has been recently reported that intralesional therapy with alpha interferon 2B resulted in significant improvement of both objective and subjective complaints (penile curvature, pain, plaque size, sexual function) associated with Peyronie's disease. Vitamin E, with its antioxidant properties, may play a role in reducing the inflammatory response. This study was designed to determine the safety and effectiveness of a high dose of alpha INF-2B injected weekly into the Peyronie's plaque combined with oral Vitamin E therapy. Twenty-nine patients with Peyronie's disease were evaluated with penile duplex Doppler for degree of penile curvature, deformity, and plaque size both prior to and after treatment. Each patient then received 4.0 x 10(6) units of alpha INF-2B in 10 cc of normal saline after appropriate local anesthesia. Injections were given once per week directly into the Peyronie's plaque for a period of 10 weeks. Patients also received 400 units of Vitamin E by mouth twice a day. Subjective data was obtained via a questionnaire prior to and at the conclusion of the study. Preliminary results demonstrated improvement of penile curvature in 39% of patients, with one patient experiencing complete resolution. Significant decreases in plaque sizes were noted in 11 of these patients, with softening of the plaques noted in all patients completing the study. Seven patients dropped out of the study prior to completing the 10 weeks: three with severe disease proceeded to surgery, two were lost to follow-up, one had exascerbation of his arthritis symptoms, and one quit secondary to flu-like symptoms. Subjective data from questionnaires revealed improvement in sexual function in those men with decreased curvature and plaque size. Weekly intralesional injections with 4.0 x 10(6) units improved plaque consistency and decreased curvature and plaque size (P < 0.5). Overall subjective sexual performance was reportedly improved. Increased dosage of alpha INF-2B resulted in increased severity of flu-like symptoms when compared to the lower (1 x 10(6) units) biweekly dosage. No significant difference was noted with the addition of oral Vitamin E therapy.
authors.affiliation: Urological Residency Program, Walter Reed Medical Center, Washington, DC, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Novak
authors.forename: W
authors.initials: W
authors.lastname: Bryan
authors.forename: L
authors.initials: L
authors.lastname: Templeton
authors.forename: S
authors.initials: S
authors.lastname: Sikka
authors.forename: W J
authors.initials: WJ
authors.lastname: Hellstrom
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007267:Injections; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D011994:Recombinant Proteins; D018616:Ultrasonography, Doppler, Duplex; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014810:Vitamin E