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Local interferon-alpha 2b is not an effective treatment in early-stage Peyronie's disease
H E Wegner1, R Andresen, H H Knispel
1Department of Urology, Benjamin Franklin Medical Center, Free University School of Medicine, Berlin, Germany.
Objective:
Peyronie's disease is characterized by an acquired penile deviation that may lead to severe penile deformity. It is refractory to most conservative therapy, and surgical correction is therefore the treatment of choice once the disease process has come to a halt. Basic science, as well as our first clinical results on the use of interferons (IFNs), have been promising, suggesting a beneficial effect in the early noncalcified disease stage.
Material And Methods:
From July 1994 to October 1995, 30 patients suffering from early Peyronie's disease were treated with three local injections of 3 million units of IFN-alpha 2b each into the plaque(s). The interval between the injections was 1 week. Patients were assessed clinically and ultrasonographically 6 months after the last injection.
Results:
Peyronie's disease clinically improved in only 1 case, remained stable in 26 patients and worsened in 3. In 7 patients, a total of 10 plaques at different sites were detected. By ultrasonography the treated plaques now showed calcifications in 3 cases, remained unchanged in 26 and could not be detected in 1 case. Of the 10 new plaques, 2 showed calcifications. Side effects (myalgia, fever) were considerable; in 74 of 90 injections, fever > 38 degrees C occurred, and a total of 8 working days were lost.
Conclusion:
IFN-alpha 2b, given according to our regimen, is not useful for the treatment of Peyronie's disease in the early stage since the disease progress continues at different sites in about 25% of the patients, and the side effects are untolerable. Our results also demonstrate that local therapy is not indicated in Peyronie's disease.
Insights
Interferon alfa 2b injections did not effectively treat early Peyronie's disease, with disease progression in 25% of patients. The treatment also caused significant side effects, making it unsuitable for patients.
Area of Science:
- Urology
- Andrology
- Pharmacology
Background:
- Peyronie's disease involves penile deviation and deformity, often resistant to conservative treatments.
- Surgical intervention is typically the preferred treatment for advanced Peyronie's disease.
- Early research suggested Interferons (IFNs) might benefit early-stage, noncalcified Peyronie's disease.
Purpose of the Study:
- To evaluate the efficacy and safety of local Interferon alfa 2b (IFN-alpha 2b) injections for early-stage Peyronie's disease.
Main Methods:
- Thirty patients with early Peyronie's disease received three weekly local injections of 3 million units of IFN-alpha 2b.
- Clinical and ultrasonographic assessments were performed six months post-treatment.
Main Results:
- Clinical improvement was observed in only one patient; 26 remained stable, and 3 worsened.
- Ultrasonography revealed new plaque formations in 7 patients, with calcifications developing in some.
- Significant side effects, including fever and myalgia, occurred in a high percentage of injections, leading to lost workdays.
Conclusions:
- Local IFN-alpha 2b injections are not effective for treating early Peyronie's disease.
- The treatment regimen resulted in disease progression in approximately 25% of patients.
- The high incidence of intolerable side effects and lack of efficacy indicate that local therapy is not indicated for Peyronie's disease.