How collagenase clostridium histolyticum data can aid in shared decision-making in Peyronie disease

In this video, Matthew J. Ziegelmann, MD, shares the take-home message from the recent Urology paper, “Incremental Treatment Response by Cycle With Collagenase Clostridium Histolyticum for Peyronie's Disease: a Pooled Analysis of Two Phase 3 Trials.” Ziegelmann is a urologist at Mayo Clinic in Rochester, Minnesota.

Transcription:

What is the take-home message for the practicing urologist?

I think the take-home message for this study is that we know collagenase [clostridium histolyticum (Xiaflex)] significantly reduces penile curvature for the majority of patients who receive this therapy. In most patients, it is not going to make the penis completely straight, but it's going to result in a meaningful improvement in their curve. Not everyone will achieve those results, but the majority of patients will, and we can now give patients definitive numbers to say, "This is the percentage of patients who, if they didn't respond to the initial treatment, are likely to go on to have a subsequent response." Now, that doesn't mean that patients should take that data and say, "Okay, well, definitely, let's continue." They should take that information and have shared decision-making with their clinician to say, "Is this the right treatment? Or should we think about some alternative treatment option, whether that's traction devices or surgical therapy?" But it's just a really helpful piece of information with which to counsel our patients, and I think most of those clinicians, including myself, who do a lot of this, we have that conversation very regularly with our patients.

Is there anything you would like to add?

Collagenase is a really important part of our treatment armamentarium. It's not the only treatment that we have available, and so I think the most important part of treatment of this condition in general is seeing someone who has the expertise to be able to offer all of these different treatments and understands the literature and so can use this information to counsel their patients.