Clostridium histolyticum collagenase (Xiapex®) in patients with peyronie disease. Expectations vs reality

Abstract

[eng] Introduction: Peyronie's disease conditions the deformity of the penis. Its etiology and effective treatment to prevent surgery have not been determined. The approval of Xiapex®, collagenase from Clostridium histolyticum, generated great expectations. Justification and objectives: Drug of recent use in Europe that requires multicenter studies to support its application. The aim is to collect the clinical results obtained from the implantation of Xiapex®. Material and methods: A study of 24 patients treated with Xiapex® between 2017 and 2020 was carried out. Previous data was collected in consultation and information on the results by telephone questionnaire. Results: The initial deviation was 61.4 degrees with a dorsal direction in 59%. 77% of the patients completed the 4 cycles. 41% reported having improved and would recommend the use of Xiapex®. 95% improved penile pain. Discussion: Numerous studies have been published on Xiapex®. Many focus on modifying the treatment scheme proposed by the manufacturer, either by reducing the number of cycles or by the use of vacuum or traction devices. It is known that it is a disease with an important psychological profile, so it is necessary to consider the assessment of subjective results. Conclusions: New studies are needed to collect and assess the real ability to modify the course of the disease with Xiapex®. It is necessary to insist on clear and concise inclusion and exclusion criteria, as well as a treatment scheme that achieves reproducible results.