Predictors of treatment success after Collagenase clostridium histolyticum injection for Peyronie's disease. Development of a nomogram from a multicentre single-arm, non-placebo controlled clinical study

To build-up a nomogram able to predict treatment success after Collagenase clostridium histolyticum (CCH) for Peyronie's disease (PD).

From November 2016 to November 2017, we enrolled 135 patients with PD in a multicentre single-arm prospective study. All patients enrolled had a treatment with CCH. Success of therapy was defined as a penile curvature decrease of at least 20 degrees from baseline curvature. Treatment satisfaction was assessed using a scale from 1 to 10 and high satisfaction was arbitral defined as a score ≥8. The calcification level was classified as: absence of calcifications, low spots perilesional calcifications and high calcification.

Median age was 56.0 (IQR [interquartile range]: 45.0,65.0) and median penile curvature (PC) was 30 degrees (IQR: 30.0,60.0). After the treatment protocol, we observed a significant median change for PC of -20.0 (p<0.01). The median percentage of penile curvature improvement was 44 (IQR: 28.0-67.0). Overall median satisfaction was 8.0 (IQR: 7.0-9.0). In total, treatment efficacy was reported in 77 patients (57.04%). When analysing factors associated with PC improvement after treatment, we found that baseline PC (OR= 1.14; p<0.01), basal plaque (OR= 64.27; p<0.01), low calcification (OR= 0.06; p<0.01) and high-calcification (OR= 0.03; p<0.01) were significant predictors of penile curvature improvement. The c-index for the model was 0.93.

Patients with longer duration of the disease, greater baseline curvature and basal plaque localization were at greater chance of treatment success. These results could be applied into clinical practice before external validation of our nomogram. This article is protected by copyright. All rights reserved.

BJU international. 2018 May 23 [Epub ahead of print]

Andrea Cocci, Giorgio Ivan Russo, Alberto Briganti, Andrea Salonia, Giovanni Cacciamani, Marco Capece, Marco Falcone, Massimiliano Timpano, Gianmartin Cito, Paolo Verze, Bruno Giammusso, Giuseppe Morgia, Vincenzo Mirone, Andrea Minervini, Mauro Gacci, Tommaso Cai, Sergio Serni, Marco Carini, Gianluca Giubilei, Nicola Mondaini

Department of Urology, Careggi Hospital University of Florence, Florence, Italy., Department of Surgery, Urology section, University of Catania, Catania, Italy., Department of Urology, Urological Research Institute Vita-Salute University San Raffaele Scientific Institute, Milan, Italy., Department of Urology, University of Verona, Verona, Italy., Department of Urology, University of Naples, Naples, Italy., Department of Urology, Molinette Hospital University of Turin, Turin, Italy., Urology Clinic Policlinic "Morgagni", Catania, Italy., Department of Urology, Santa Chiara Regional Hospital, Trento, Italy., Department of Urology, Santa Maria Annunciata Hospital, Florence, Italy.


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