World J Mens Health.  2016 Apr;34(1):40-46. 10.5534/wjmh.2016.34.1.40.

The Efficacy of Medical Treatment of Peyronie's Disease: Potassium Para-Aminobenzoate Monotherapy vs. Combination Therapy with Tamoxifen, L-Carnitine, and Phosphodiesterase Type 5 Inhibitor

Affiliations
  • 1Department of Urology, Korea University College of Medicine, Seoul, Korea. dgmoon@korea.ac.kr

Abstract

PURPOSE
This study was designed to evaluate the efficacy of medical treatment of Peyronie's disease.
MATERIALS AND METHODS
A total of 109 patients with Peyronie's disease who had been treated from January 2011 to December 2014 were retrospectively reviewed in this study. Forty-four patients (Group 1) were treated with 12 mg of potassium para-aminobenzoate daily. Sixty-five patients (Group 2) were treated with combination therapy: tamoxifen (20 mg) and acetyl-L-carnitine (300 mg) twice daily in addition to a phosphodiesterase type 5 inhibitor. Ability to perform sexual intercourse, pain during erection, size of plaque, and penile curvature angle were assessed.
RESULTS
In Group 1, 30 of 44 patients (68.2%) discontinued treatment within 12 weeks, while 5 patients (7.7%) in Group 2 discontinued treatment. Pain during erection and plaque size were improved in both groups but showed no statistical difference due to the high dropout rate in Group 1. In both groups, penile curvature was improved, but demonstrated no statistical difference between the treatment groups. However, combination therapy demonstrated a better response rate in patients whose penile curvature angle was less than 30° (44.4% vs. 79.1%, p=0.048). The rate of successful sexual intercourse was significantly higher in Group 2 (42.8% vs. 78.3%, p=0.034). The number of patients who underwent surgical correction despite medical treatment was significantly higher in Group 1 (35.7% vs. 13.3%, p=0.048).
CONCLUSIONS
Early medical combination therapy in Peyronie's disease may present better results in patients whose curvature angle is less than 30°.

Keyword

Drug therapy, combination; Penile induration; 4-Aminobenzoic acid

MeSH Terms

4-Aminobenzoic Acid
Acetylcarnitine
Carnitine*
Coitus
Drug Therapy, Combination
Humans
Male
Patient Dropouts
Penile Induration*
Potassium*
Retrospective Studies
Tamoxifen*
4-Aminobenzoic Acid
Acetylcarnitine
Carnitine
Potassium
Tamoxifen

Cited by  2 articles

Nonsurgical Interventions for Peyronie's Disease: Update as of 2016
Gregory A Joice, Arthur L Burnett
World J Mens Health. 2016;34(2):65-72.    doi: 10.5534/wjmh.2016.34.2.65.

Extracorporeal Shock Wave Therapy in Peyronie's Disease: Clinical Efficacy and Safety from a Single-Arm Observational Study
Marina di Mauro, Giorgio Ivan Russo, Pier Andrea Della Camera, Fabrizio di Maida, Gianmartin Cito, Nicola Mondaini, Marco Capece, Marco Falcone, Francesco Sessa, Andrea Mari, Riccardo Campi, Carlotta Sabini, Sergio Serni, Mauro Gacci, Andrea Minervini, Marco Carini, Sebastiano Cimino, Girolamo Morelli, Andrea Cocci
World J Mens Health. 2019;37(3):339-346.    doi: 10.5534/wjmh.180100.


Reference

1. Hellstrom WJ, Bivalacqua TJ. Peyronie's disease: etiology, medical, and surgical therapy. J Androl. 2000; 21:347–354.
2. Smith CJ, McMahon C, Shabsigh R. Peyronie's disease: the epidemiology, aetiology and clinical evaluation of deformity. BJU Int. 2005; 95:729–732.
Article
3. Schwarzer U, Sommer F, Klotz T, Braun M, Reifenrath B, Engelmann U. The prevalence of Peyronie's disease: results of a large survey. BJU Int. 2001; 88:727–730.
Article
4. Gonzalez-Cadavid NF, Rajfer J. Treatment of Peyronie's disease with PDE5 inhibitors: an antifibrotic strategy. Nat Rev Urol. 2010; 7:215–221.
Article
5. Segal RL, Burnett AL. Surgical management for Peyronie's disease. World J Mens Health. 2013; 31:1–11.
Article
6. Hatzimouratidis K, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Salonia A, et al. European Association of Urology. EAU guidelines on penile curvature. Eur Urol. 2012; 62:543–552.
Article
7. Zarafonetis CJ, Horrax TM. Treatment of Peyronie's disease with potassium para-aminobenzoate (potaba). J Urol. 1959; 81:770–772.
Article
8. Ralph DJ, Brooks MD, Bottazzo GF, Pryor JP. The treatment of Peyronie's disease with tamoxifen. Br J Urol. 1992; 70:648–651.
Article
9. Teloken C, Rhoden EL, Grazziotin TM, Ros CT, Sogari PR, Souto CA. Tamoxifen versus placebo in the treatment of Peyronie's disease. J Urol. 1999; 162:2003–2005.
Article
10. Bonavita E. Study of the efficacy and tolerability of L-acetylcarnitine therapy in the senile brain. Int J Clin Pharmacol Ther Toxicol. 1986; 24:511–516.
11. Valente EG, Vernet D, Ferrini MG, Qian A, Rajfer J, Gonzalez-Cadavid NF. L-arginine and phosphodiesterase (PDE) inhibitors counteract fibrosis in the Peyronie's fibrotic plaque and related fibroblast cultures. Nitric Oxide. 2003; 9:229–244.
Article
12. Chung E, Deyoung L, Brock GB. The role of PDE5 inhibitors in penile septal scar remodeling: assessment of clinical and radiological outcomes. J Sex Med. 2011; 8:1472–1477.
Article
13. Shah PJR, Green NA, Adib RS, Stewart PAH, Smith P, Coxon JG, et al. A multicentre double blind controlled trial of potassium paraaminobenzoate (Potaba) in Peyronie's disease. Prog Reprod Biol Med. 1983; 9:61–67.
14. Weidner W, Hauck EW, Schnitker J. Peyronie's Disease Study Group of Andrological Group of German Urologists. Potassium paraaminobenzoate (POTABA) in the treatment of Peyronie's disease: a prospective, placebo-controlled, randomized study. Eur Urol. 2005; 47:530–535.
Article
15. Wahl SM, McCartney-Francis N, Mergenhagen SE. Inflammatory and immunomodulatory roles of TGF-beta. Immunol Today. 1989; 10:258–261.
16. Biagiotti G, Cavallini G. Acetyl-L-carnitine vs tamoxifen in the oral therapy of Peyronie's disease: a preliminary report. BJU Int. 2001; 88:63–67.
Article
17. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie's disease. Curr Urol Rep. 2005; 6:454–460.
Article
18. Cavallini G, Biagiotti G, Koverech A, Vitali G. Oral propionyl-l-carnitine and intraplaque verapamil in the therapy of advanced and resistant Peyronie's disease. BJU Int. 2002; 89:895–900.
Article
19. Safarinejad MR, Hosseini SY, Kolahi AA. Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie's disease: a double-blind, placebo controlled, randomized study. J Urol. 2007; 178:1398–1403.
Article
20. Ferrini MG, Kovanecz I, Nolazco G, Rajfer J, Gonzalez-Cadavid NF. Effects of long-term vardenafil treatment on the development of fibrotic plaques in a rat model of Peyronie's disease. BJU Int. 2006; 97:625–633.
Article
21. Palmieri A, Imbimbo C, Creta M, Verze P, Fusco F, Mirone V. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie's disease and erectile dysfunction: results from a prospective randomized trial. Int J Androl. 2012; 35:190–195.
Article
22. Wunderlich H, Werner W, Schubert J. Coincidence of induratio penis plastica and erectile dysfunction. Urol Int. 1998; 60:97–100.
Article
23. Weidner W, Schroeder-Printzen I, Weiske WH, Vosshenrich R. Sexual dysfunction in Peyronie's disease: an analysis of 222 patients without previous local plaque therapy. J Urol. 1997; 157:325–328.
Article
24. Kadioğlu A, Tefekli A, Erol H, Cayan S, Kandirali E. Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease. Int J Impot Res. 2000; 12:263–267.
Article
25. Levine LA, Latchamsetty KC. Treatment of erectile dysfunction in patients with Peyronie's disease using sildenafil citrate. Int J Impot Res. 2002; 14:478–482.
Article
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