108 Intralesional Collagenase Clostridium Histolyticum Causes Meaningful Improvement in Men with Peyronie’s Disease: The Results of a Multi-institutional Analysis

Abstract

Peyronie’s disease (PD), defined as the abnormal formation of a fibrous plaque(s) in the tunica albuginea of the penis, is a chronic and distressing condition that affects 3-13% of the adult male population. Collagenase Clostridium histolyticum (CCH) is an injectable agent that enzymatically degrades the abnormal interstitial collagen in PD plaques, and was documented in the IMPRESS trials to reduce penile curvature by an average of 35%. Since these trials, a number of single center studies have been conducted to evaluate the safety and efficacy of CCH in different settings with varying protocols. However, there have not been any published studies analyzing the effect of CCH on patients with PD in a multi-institutional analysis that follows the IMPRESS trials protocol. To evaluate, in a real-world setting, the efficacy/safety outcomes of multiple high-volume centers employing CCH to treat PD. Retrospective data were collected for consecutive patients with PD who underwent treatment with CCH between April 2014 and March 2018 at five institutions. 918 patients were included. Main outcomes of interest include the change in curvature after receiving CCH therapy, and frequency of serious treatment-related adverse events. Other variables of interest included patient age, penile curvature measurements (defined as the largest single plane curvature), curvature direction, plaque location, duration of PD, and number of CCH cycles received. Two-tailed paired Student t-test was used for comparisons of continuous variables. Univariate and multivariate logistic regression analyses were performed to assess predictors of success of CCH therapy in improving curvature, defined as a ≥20% improvement in curvature, and global response scores.