Comparing the effectiveness and safety of intralesional verapamil and collagenase Clostridium histolyticum injections in men with Peyronie’s disease.

This study compared the effectiveness and safety of intralesional verapamil (Calan; ILV) and collagenase Clostridium histolyticum (Xiaflex; CCH) injections in men with Peyronie’s disease (PD). The data showed that CCH therapy was more effective than ILV, with a higher high level of patient satisfaction rate in the short term and with manageable side effects.

Peyronie’s disease (PD) is a condition that causes a curvature in the penis. The curve or bend is caused by a build-up of fibrous tissue on the penis shaft. These are called plaques. PD can lead to pain and erectile dysfunction (ED). It is unclear what causes PD.

There are few treatment options for men with PD. There is only one approved drug called collagenase clostridium hystoliticum (CCH). It is an enzyme that breaks up collagen protein. Collagen is one of the components of plaques in PD.

Intralesional verapamil (ILV) involves injecting verapamil into PD lesions (plaques). This breaks down the plaques. Verapamil is a calcium channel blocker that could improve penile curvature and plaque size without impacting erectile function. However, the effectiveness and safety of ILV compared to CCH injections in men with PD are still unknown.

This study involved 50 men with PD. Patients were randomly assigned into 2 groups. Group 1 included 25 patients who received CCH therapy. Group 2 included 25 patients who received ILV therapy. The patients were followed up for 24 months. Penile curvature, erectile function, and patient satisfaction were evaluated through standardized questionnaires. Patients were also asked about the psychological and physical impact of PD.

Penile curvature improved in both groups. Penile curvature was reduced by 28.2 degrees in group 1 compared to 16.8 degrees in group 2. This difference was considered statistically significant.

Psychological and sexual scores improved in both groups. Psychosexual scores were reduced by 2.9 points in group 1 compared to 2.14 in group 2. This difference was considered statistically significant.

The overall satisfaction rate on a 5-point scale was 4.5 in group 1 and 4.1 in group 2. Minor treatment-related side effects events were more common in group 1 than in group 2. Side effects included penis bruising, pain, and swelling. 

This study concluded that CCH therapy was more effective, with a higher high level of patient satisfaction rate in the short term compared to ILV for the treatment of men with PD, with manageable side effects.

The sample size was very small. This study did not include a placebo group. Patients knew which treatment they were getting which might affect the conclusions.