MP65-10 COMPARISON OF STANDARDIZED INTRALESIONAL INJECTION OF INTERFERON 2-ALPHA-2B (IFN) AND COLLAGENASE CLOSTRIDIUM HISTOLYTICIUM (CCH) FOR PEYRONIE’S DISEASE (PD) AT SINGLE HEALTH CENTER

Abstract

INTRODUCTION AND OBJECTIVES: Utilization of intrale-sional therapy for the treatment of PD has increased dramatically since FDA approval of CCH for this indication in 2013. This poses a significant economic burden to healthcare systems due to pharmaceutical costs. Intralesional injection of both CCH and IFN are recommended according to AUA guidelines. Previous literature comparing CCH and IFN demonstrated similar efficacy, though in a non-standardized fashion across multiple medical centers. The goal of this actively enrolling study is to compare clinical outcomes for intralesional injections of CCH and a lower-cost alternative, IFN, in a standardized fashion at a single health organization. METHOD(S): Patients with PD were offered both intralesional options, unless contraindicated, for noncalcified stable penile lesions inducing curvature between 30 to 90 degrees. Injections were conducted in a standardized fashion with a cycle of two intralesional injections 24-72 hours apart according to the single-puncture protocol into the plaque at site of maximal concavity followed by daily at-home modeling. This cycle was repeated for up to four iterations, 6-7 weeks apart. Curvature was measured on the first day of each cycle with a pharmacologic erection. IFN injections consisted of 0.25 mL, 2.5 million IU while CCH included 0.58 mg. Clinical outcomes were measured in prospective fashion. RESULT(S): Seventeen men with PD were acceptable intralesional candidates and met study inclusion criteria. Six men opted for CCH, 11 for IFN injections. All patients had a dorsal plaques resulting in baseline curvature of 45degree to 90degree, mean 57degree. IFN patients had a baseline curvature between 37-85degree, mean 55.6degree. CCH cohort had a baseline between 45-90degree with a mean of 61.2degree, p= 0.48). The IFN cohort received 31 injections (mean 2.8 injection/patient) for a list cost of $5,301 while 11 CCH injections (mean 1.8) for a cost of $51,678. Ten of the 11 men demonstrated improvement of penile curvature, overall mean 12.6degree or 23% improvement from baseline deformity. Patients treated with CCH had a modest improvement of 3 degrees or 8% improvement. IFN patients had a modest improvement in Sexual Health Inventory for Men (SHIM) scores (mean 1.3) across treatment sessions while SHIM scores decreased for CCH patients (mean -8.2). Similarly, patients treated with IFN had a decline in Peyronie's Disease Ques-tionaire (PQD) bother score (3.05), while CCH patients remained stable (-0.25). There were no significant complications in either treatment arm. CONCLUSION(S): Intralesional IFN is a viable option at a fraction of the cost compared to CCH. This is the first study to compare intralesional injection of IFN and CCH in a standardized fashion at a single institution.