Mayo Clinic, Rochester, MN, USA.
Male Fertility and Peyronie's Clinic, Orem, UT, USA.
Int J Impot Res. 2023 Mar;35(2):147-151. doi: 10.1038/s41443-021-00522-8. Epub 2022 Jan 10.
Collagenase clostridium histolyticum (CCH) is an injectable therapy targeting collagen present in penile plaques in Peyronie's disease (PD). Data comparing CCH to penile surgery are limited, and long-term therapeutic outcomes are unknown. This retrospective analysis used a US claims database (January 2014-June 2017) to determine the percentage of men with subsequent penile surgery among those who initially received CCH (n = 1227) or surgery (index treatment; n = 620) for PD. Eligible patients were aged ≥18 years with continuous enrollment ≥6 months before and ≥12 months after index treatment date. During 12 months of post-index treatment follow-up, fewer patients with PD initially treated with CCH (4.6% [56/1227]) had subsequent penile surgery versus those initially treated with penile surgery (10.3% [64/620]; p < 0.0001). Mean ± SD time to first subsequent surgery after initial PD treatment was longer in the CCH versus surgery cohort (7.7 ± 3.0 vs 1.7 ± 3.2 months). The likelihood of subsequent surgery varied by initial surgery type: 18.2% after plaque incision or excision with grafting; 11.6% after penile implant; and 8.2% after tunical plication. Patients with PD who received CCH first were less likely to undergo subsequent surgery compared with those who received surgery first within a 12-month post-treatment follow-up.
胶原酶溶组织梭菌（CCH）是一种注射疗法，针对的是佩罗尼氏病（PD）阴茎斑块中的胶原。将 CCH 与阴茎手术进行比较的数据有限，长期治疗效果尚不清楚。本回顾性分析使用了美国索赔数据库（2014 年 1 月至 2017 年 6 月），以确定在最初接受 CCH（n=1227）或手术（索引治疗；n=620）治疗 PD 的男性中，有多少人随后进行了阴茎手术。符合条件的患者年龄≥18 岁，在索引治疗日期前至少连续入组 6 个月，在索引治疗日期后至少连续入组 12 个月。在索引治疗后 12 个月的随访期间，与最初接受手术治疗的 PD 患者（10.3%[64/620]）相比，最初接受 CCH 治疗的患者（4.6%[56/1227]）随后接受阴茎手术的比例较低（p<0.0001）。CCH 组与手术组首次后续手术的平均时间（7.7±3.0 比 1.7±3.2 个月）更长。初始治疗后首次后续手术的可能性因初始手术类型而异：斑块切开或切除伴移植物 18.2%；阴茎植入 11.6%；和 8.2%的阴茎筋膜折叠术。在 12 个月的治疗后随访期间，与那些首先接受手术治疗的患者相比，首先接受 CCH 治疗的 PD 患者接受后续手术的可能性较低。
