156 Intralesional Collagenase Clostridium Histolyticum Therapy for Peyronie's Disease is Safe in Patients Continuing Antiplatelet and Anticoagulant Therapy: A Single Center Experience

Abstract

The initial clinical trials for intralesional collagenase Clostridium histolyticum (CCh) injection therapy for Peyronie’s disease (PD) excluded men on anticoagulant or antiplatelet medications except those on low-dose aspirin. Men with PD who take blood thinners present a challenging clinical scenario due to a lack of evidence regarding the safety of CCh while on anticoagulant or antiplatelet therapy. Blood thinning medications critically prevent cardiovascular mortality, and therefore their suspension for a non-life-threatening condition is problematic. Physicians may want to offer CCh to these patients without discontinuing these drugs, however they face the dilemma of having insufficient evidence of the drug’s safety while on such medication. This study aimed to evaluate safety outcomes among patients continuing anticoagulant and antiplatelet therapy during ongoing intralesional CCh injection treatment for PD. An institutional review board approved database of 187 patients treated with CCh at an academic men’s health practice from January 2016 through April 2019 was reviewed. Data on patient demographics, comorbidities, CCh injection details, use or non-use of blood thinner medications, and adverse events were extracted from the electronic medical record. Rates of hematoma formation, bruising, swelling, and corporal rupture were determined. Univariate statistical analysis compared clinical data and adverse events between men on or off blood thinner medications.