(293) PEYRONIE’S DISEASE PATIENT JOURNEY: AN EXTENSIVE ELECTRONIC MEDICAL RECORD ANALYSIS

Abstract

Introduction: Peyronie's Disease (PD) can have a devastating effect on a man's sexual function and overall well-being. Although effective treatment options are available, data suggest that even when diagnosed appropriately, PD remains an undertreated condition. PD treatment can prevent worsening of symptoms, and PD is unlikely to resolve without it. Effective treatment includes injections of collagenase clostridium histolyticum (CCH), and surgical options, including tunical plication, incision/excision with grafting and penile prosthesis implantation, to affect penile straightening. Other PD treatments with limited efficacy data include verapamil injections or oral pentoxifylline and vitamin E. There is a lack of realworld data from large cohorts on the prevalence of men with PD symptoms and their treatment patterns. Objective: To describe the demographics, clinical characteristics, and treatment patterns of men diagnosed with PD. Methods: This retrospective analysis used the largest available US Urology integrated database, PPS Analytics (Specialty Networks). Data acquisition included structured data found in practice management systems and from clinical notes in electronic medical records using natural language processing. Approximately 67,275 patients with PD were identified all of whom were treated at 90 community urology practices between 01/01/2014 and 09/30/2021. Results: This study revealed that 75.3% of patients diagnosed with PD had not received any prior treatment, with 90.6% of the cohort being age 45 years or older. Of the 16,610 PD patients who did receive PD treatment, themost common therapies were CCH (45.05%), pentoxifylline (30.90%), and surgical interventions (23.55%). The average time to treatment initiation (TTI) from initial PD diagnosis for all therapies was 221 days. Amongst known medical and surgical therapies, CCH demonstrated the shortest TTI average (271 vs 381 days for surgical interventions). Of the 7483 patients who received CCH, 90.87% used it as their first therapy, highlighting its preference as an initial treatment option. Surgical treatment was received by 3200 patients, and only 64.58% started with it as their first therapy. Conclusions: This study highlights TTI and therapeutic patterns for the largest group of PD patients ever reported. These data emphasize the importance of timely diagnosis and suitable treatment selection. The reduced TTI for CCH therapy suggests its potential as an evidence-based treatment with the ability to alleviate the burdens of PD patients earlier and less invasively than surgery.