The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies
Background: Peyronie’s disease (PD) is a progressive fibrotic disorder of the penis that is adverse to men’s health. Currently, effective and reliable non-surgical options for PD are limited. Since the Food and Drug Administration (FDA) approved it in 2013, intralesional injection of collagenase Clo...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.973394/full |
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| author | Fuxun Zhang Fuxun Zhang Yang Xiong Yang Xiong Wei Wang Wei Wang Changjing Wu Feng Qin Jiuhong Yuan Jiuhong Yuan |
| author_facet | Fuxun Zhang Fuxun Zhang Yang Xiong Yang Xiong Wei Wang Wei Wang Changjing Wu Feng Qin Jiuhong Yuan Jiuhong Yuan |
| author_sort | Fuxun Zhang |
| collection | DOAJ |
| description | Background: Peyronie’s disease (PD) is a progressive fibrotic disorder of the penis that is adverse to men’s health. Currently, effective and reliable non-surgical options for PD are limited. Since the Food and Drug Administration (FDA) approved it in 2013, intralesional injection of collagenase Clostridium histolyticum (CCH) became the only licensed treatment for PD. This meta-analysis aims to evaluate the clinical efficacy and safety of CCH in treating PD, predominantly based on post-FDA studies.Methods: The primary outcome was clinical efficacy evaluated by the percentages of improvement in penile curvature (PC) and Peyronie’s disease symptom bother score (PD bother score). The secondary outcome was the safety assessed by treatment-related adverse events (TRAEs). Heterogeneity was assessed by Cochran’s Q and I2 tests. Sensitivity and subgroup analyses were performed to explore the source of heterogeneity. Funnel plots and Egger’s test were used to evaluate the publication bias.Results: A total of 11 studies with 1,480 intentions to treat (ITT) population were included. The pooled effect of the improvement of PC was 35% (95% CI: 0.33–0.38), and the pooled improvement of the PD bother score was 41% (95% CI: 0.37–0.45). No heterogeneity was found at the pooled improvement of PC (p = 0.845, I2 = 0.00%). Meanwhile, some heterogeneity existed in the pooled improvement of the PD bother score (p = 0.069, I2 = 43.4%). The pooled effect of TRAEs was 93% (95% CI 0.88–0.97) with significant heterogeneity (p < 0.000, I2 = 92.3%).Conclusion: The intralesional injection of CCH could significantly improve the penile deformity of PD patients. Meanwhile, CCH appears to ameliorate the PD bother score to some extent and has acceptable clinical safety. Future studies are required to clarify the long-term outcomes of CCH injection in the treatment of PD. |
| first_indexed | 2024-04-12T01:41:58Z |
| format | Article |
| id | doaj.art-b77cf2db88ff496589958e82f79d8097 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T01:41:58Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-b77cf2db88ff496589958e82f79d80972022-12-22T03:53:10ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-10-011310.3389/fphar.2022.973394973394The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studiesFuxun Zhang0Fuxun Zhang1Yang Xiong2Yang Xiong3Wei Wang4Wei Wang5Changjing Wu6Feng Qin7Jiuhong Yuan8Jiuhong Yuan9Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaAndrology Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaAndrology Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaAndrology Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaAndrology Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaAndrology Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaBackground: Peyronie’s disease (PD) is a progressive fibrotic disorder of the penis that is adverse to men’s health. Currently, effective and reliable non-surgical options for PD are limited. Since the Food and Drug Administration (FDA) approved it in 2013, intralesional injection of collagenase Clostridium histolyticum (CCH) became the only licensed treatment for PD. This meta-analysis aims to evaluate the clinical efficacy and safety of CCH in treating PD, predominantly based on post-FDA studies.Methods: The primary outcome was clinical efficacy evaluated by the percentages of improvement in penile curvature (PC) and Peyronie’s disease symptom bother score (PD bother score). The secondary outcome was the safety assessed by treatment-related adverse events (TRAEs). Heterogeneity was assessed by Cochran’s Q and I2 tests. Sensitivity and subgroup analyses were performed to explore the source of heterogeneity. Funnel plots and Egger’s test were used to evaluate the publication bias.Results: A total of 11 studies with 1,480 intentions to treat (ITT) population were included. The pooled effect of the improvement of PC was 35% (95% CI: 0.33–0.38), and the pooled improvement of the PD bother score was 41% (95% CI: 0.37–0.45). No heterogeneity was found at the pooled improvement of PC (p = 0.845, I2 = 0.00%). Meanwhile, some heterogeneity existed in the pooled improvement of the PD bother score (p = 0.069, I2 = 43.4%). The pooled effect of TRAEs was 93% (95% CI 0.88–0.97) with significant heterogeneity (p < 0.000, I2 = 92.3%).Conclusion: The intralesional injection of CCH could significantly improve the penile deformity of PD patients. Meanwhile, CCH appears to ameliorate the PD bother score to some extent and has acceptable clinical safety. Future studies are required to clarify the long-term outcomes of CCH injection in the treatment of PD.https://www.frontiersin.org/articles/10.3389/fphar.2022.973394/fullPeyronie’s diseasecollagenase Clostridium histolyticumtreatmentefficacysafety |
| spellingShingle | Fuxun Zhang Fuxun Zhang Yang Xiong Yang Xiong Wei Wang Wei Wang Changjing Wu Feng Qin Jiuhong Yuan Jiuhong Yuan The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies Frontiers in Pharmacology Peyronie’s disease collagenase Clostridium histolyticum treatment efficacy safety |
| title | The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies |
| title_full | The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies |
| title_fullStr | The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies |
| title_full_unstemmed | The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies |
| title_short | The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie’s disease: A meta-analysis of published prospective studies |
| title_sort | efficacy and safety of intralesional injection of collagenase clostridium histolyticum for peyronie s disease a meta analysis of published prospective studies |
| topic | Peyronie’s disease collagenase Clostridium histolyticum treatment efficacy safety |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.973394/full |
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