Extract

Objectives

The medical treatment of Peyronie’s disease (PD) in term of intralesional therapy is still a matter of debate. We aimed to compare the clinical efficacy of different classes of intralesional therapy through a network meta-analysis method.

Material and Methods

The search was conducted until 30 September 2017 using Medline, Scopus and Web of Science databases without restriction on year of publication, using PICO review protocol. We included randomized controlled studies comparing at least one intralesional therapy with placebo or with another drug in the treatment of Peyronie’s disease. All intralesional therapy have been considered: Collagenase c. Histolytcum (CCH) , Hyaluronic acid, Verapamil and Interferon-alpha-2b. Outcomes of the study were the mean change in penile curvature (PC) and in erectile function (EF) assessed with the International Index of Erectile Function (IIEF) questionnaire.

Results

In total, 1721 articles were identified after the electronic search in PubMed (n = 646), Scopus (n = 629) and Web of Science (n = 446). After the global assessment, 8 studies matched with the inclusion criteria, including 1,050 patients. We reported heterogeneity between studies based on duration of protocol and follow-up. For PC (degree), the mean efficacies against placebo were as following: Collagenase: +0.41, Hyaluronic acid: +6.25, Verapamil: +1.88 and Interferon α-2b: -0.50 (Figure 1). However, for PC mean changes between therapy, CCH showed better results versus Hyaluronic acid and Verapamil, +6.66 and +2.30, while Interferon α-2b exhibited similar results (-0.09). Interferon α-2b showed better improvement than Verapamil (-2.38) (Figure 2).

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