Pharmacologic therapy for Peyronie’s disease: what should we prescribe?

Abstract

Introduction: 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.

Areas covered: 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.

Expert opinion: 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.

Keywords:

• erectile dysfunction
• intralesional injections
• penile curvature
• penile plaque
• Peyronie’s disease
• pharmacologic therapy

Declaration of interest

LA Levine has contributed to research, acted as a lecturer and been a member of the advisory board for Auxilium Pharmaceuticals. He has been a lecturer for and been a member of the advisory board for Coloplast and also a lecturer for American Medical Systems. BA Sherer and KF Godlewski have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Notes

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