Pharmacologic therapy for Peyronie's disease: what should we prescribe?
BACKGROUND
Peyronie's disease (PD) is a wound healing disorder of the penis with a myriad of proposed treatment options reported in the literature. Evaluating the available data and therapeutic management of PD can be challenging and confusing, even for the most experienced treating physician. This review provides a comprehensive overview of pharmacologic treatment options for PD, focusing on the best available evidence.


METHODS
A comprehensive literature search for published articles evaluating oral, topical, and injectable pharmacologic agents for PD was completed. Prospective, controlled trials were given precedence for inclusion.


CONCLUSIONS
Although a multitude of oral agents have been proposed and evaluated in PD patients, results vary widely and a reproducible objective benefit has not yet been strongly established for any single oral agent. Well-designed, large-scale, randomized controlled trials evaluating oral agents in PD patients are lacking. Consistent objective benefit from injectable agents has been supported for years by various non-controlled trials. Recently, injectable collagenase Clostridium histolyticum became the first pharmacologic agent to obtain FDA approval for use in PD patients, supported by data from a large-scale, Phase III randomized controlled trial. Further elucidation of the genetic and mechanistic pathways involved in the development and progression of PD will help define future therapeutic targets.
Rush University Medical Center , 1725 W Harrison St, Chicago, IL 60612, Suite 348 , USA +1 312 563 3480 ; +1 312 563 5007 ; drlevine@hotmail.com.
Benjamin A
BA
Sherer
Karl F
KF
Godlewski
Laurence A
LA
Levine
D000284:Administration, Oral; D000287:Administration, Topical; D003094:Collagen / Q000096:biosynthesis; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D003012:Microbial Collagenase / Q000627:therapeutic use; D058990:Molecular Targeted Therapy; D058628:Myofibroblasts / Q000187:drug effects / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D010411:Penile Induration / Q000188:drug therapy* / Q000378:metabolism; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism; D016211:Transforming Growth Factor alpha / Q000378:metabolism
D017382:Reactive Oxygen Species; D016211:Transforming Growth Factor alpha; D009569:Nitric Oxide; D003094:Collagen; D003012:Microbial Collagenase
Peyronie’s disease; erectile dysfunction; intralesional injections; penile curvature; penile plaque; pharmacologic therapy