Okene Michael O, Achalu Priyanka, Hsieh Tung-Chin, Mirheydar Hossein
Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.
Department of Urology, University of California San Diego, La Jolla, CA, USA.
Perm J. 2025 Mar 14;29(1):61-68. doi: 10.7812/TPP/24.111. Epub 2024 Dec 12.
Intralesional collagenase (CCH) injection is an effective intervention for treatment of Peyronie's disease (PD). While CCH efficacy has been demonstrated in White populations, little is known about treatment efficacy in Black and Hispanic populations.
This study examined efficacy of intralesional CCH in a racially diverse population in a large integrated health care system over 15 years. Treatment efficacy was defined as percent change in penile curvature abnormality from baseline after up to 4 treatment cycles.
Of the 112 patients with PD who underwent CCH therapy, 66.1% of men were White, 22.3% were Hispanic, and 9.8% were Black. Additionally, 63.4% of men had a baseline penile curvature of 30°-59°. There were no significant differences in treatment response to CCH across different racial and ethnical groups ( = .96). There was a statistically significant difference in number of cycles completed across different ethnicities ( = .022). When adjusted for completing a full 4-cycle treatment, the Hispanic subgroup had the most patients complete fewer than 4 cycles ( = .0004). Almost half of the Hispanic subgroup (48%) reported needing an interpreter for health appointments.
This is the largest postmarket analysis of CCH treatment outcomes in a racially diverse PD population. Though there were no significant differences in treatment outcomes by race and ethnicity, Hispanic men were significantly less likely to complete 4 cycles of injection therapy. One possible explanation is a language barrier, which prevented future follow-up treatment.
The use of CCH treatment for PD is an effective option for racially diverse patient populations.
病灶内注射胶原酶（CCH）是治疗佩罗尼氏病（PD）的一种有效干预措施。虽然CCH在白人人群中的疗效已得到证实，但对于黑人和西班牙裔人群的治疗效果知之甚少。
本研究在一个大型综合医疗保健系统中，对15年间不同种族人群病灶内注射CCH的疗效进行了研究。治疗效果定义为在接受多达4个治疗周期后，阴茎弯曲异常相对于基线的变化百分比。
在接受CCH治疗的112例PD患者中，66.1%为白人男性，22.3%为西班牙裔，9.8%为黑人。此外，63.4%的男性基线阴茎弯曲度为30°至59°。不同种族和民族对CCH的治疗反应无显著差异（P = 0.96）。不同种族完成的周期数存在统计学显著差异（P = 0.022）。在调整为完成完整的4个周期治疗后，西班牙裔亚组中完成少于4个周期治疗的患者最多（P = 0.0004）。几乎一半的西班牙裔亚组患者（48%）报告在就医时需要翻译。
这是对不同种族PD人群CCH治疗结果进行的最大规模上市后分析。尽管种族和民族对治疗结果没有显著差异，但西班牙裔男性完成4个周期注射治疗的可能性明显较低。一个可能的解释是语言障碍，这阻碍了后续的随访治疗。
对于不同种族的患者群体，使用CCH治疗PD是一种有效的选择。
