Peyronie's disease is a condition in which a plaque, or hard lump, forms on the penis. It causes hardened tissue, pain, and an abnormal bending in the penis. These symptoms are more severe during an erection. Significant bending of the penis can result in pain, poor erections, and an inability to engage in sexual intercourse. This disease affects about 3% of the male population. The average age of onset of this disease is 57 years old. The cause of the disease is unknown. However, many believe that it may be due to trauma to the penis (such as injury or extremely vigorous sexual activity).
Treatments for this disease have been limited and often unsuccessful. The goal of treatment is to reduce pain and maintain sexual function. Oral medicines that prevent plaque formation and promote plaque breakdown have not been effective. Many patients with the disease will require injections of medicines directly into the plaque. These injections have been used for over 50 years in the treatment of major Peyronie's disease. The disease often resolves on its own without treatment. Surgery may be performed to remove hardened tissue in the penis. However, surgery is not done during the first 12 months of the disease. There are 2 phases of the disease: the active phase and the inactive phase. The active phase usually occurs during the first 12 months of the disease. The stabilization of the plaque is known as the inactive phase. We are inviting men with stable disease to take part in this study which will test BOTOX® versus a placebo (a placebo contains no medicine). This will be a randomized, placebo-controlled, cross-over, single-center trial. The placebo group has the option to cross over to the treatment arm (ARM 1) of the study at the end of their 16 weeks of placebo arm (ARM 2). Study drug is Botulinum toxin type A (BOTOX®). Subjects who meet the inclusion criteria for the study will be randomized to either the treatment or placebo arm. * Treatment: Injection solution will consist of 100 units of BOTOX® in 10 cc of preservative free normal saline, or * Placebo: Injection solution will consist of 10 cc preservative free normal saline.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Approximately 20 to 30 injections of 100 units of BOTOX® given with a 20 gage needle directly into the penile plaque
Approximately 20 to 30 injections of 10cc of preservative free normal saline given with a 20 gage needle directly into the penile plaque
Approximately 20 to 30 injections of 100 units of BOTOX® given with a 20 gage needle directly into the penile plaque
Baylor College of Medicine
Houston, Texas, United States
Average Percent Change of Penile Curvature in Degrees
Measured by a protractor from pictures taken at baseline (pre-treatment screening visit) and end of treatment at week 16 \*Crossover subjects were added to Experimental Group for analysis\* Negative value equates to a reduction in curvature Positive value equates to an increase in curvature
Time frame: Baseline (Pre-Treatment Screening Visit) to end of treatment at week 16
Change in Penile Blood Flow for Peak Systolic Velocity (PSV) and End-diastolic Velocity (EDV)
Results of penile doppler ultrasound from baseline/screening visit to end of treatment at week 16 will be compared. peak systolic velocity (PSV) and end-diastolic velocity (EDV) are assessed here. Change is calculated as week 16 values - screening visit values Negative values are a decrease in velocity Positive values are an increase in velocity
Time frame: Baseline (Pre-Treatment Screening Visit) to end of treatment at week 16
Change in Penile Blood Flow for Diameter
Results of penile doppler ultrasound from the baseline/screening visit to end of treatment at week 16 will be compared. Diameter is assessed here. Change is calculated as week 16 values - screening visit values Negative values are a decrease in diameter Positive values are an increase in diameter
Time frame: Baseline (Pre-Treatment Screening Visit) to end of treatment at week 16
Change in Penile Plaque Size
Results of ultrasound at baseline/screening visit to end of treatment at week 16 will be compared. \*Crossover subjects were added to Experimental Group for analysis\* Change is calculated as week 16 values values minus screening visit values Increase in value equates to increased plaque size Decrease in value equates to decreased plaque size
Time frame: Baseline (Pre-Treatment Screening Visit) to end of treatment at week 16
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Changes in International Index of Erectile Function Scores (IIEF)
Subject's average scores on IIEF at baseline/screening visit to end of treatment at week 16 are compared The subscale measures self-reported erectile function. Maximum score is 30, Minimum is 0. A score of 0 is the absolute best outcome. A score of 30 is the absolute worst outcome. Erectile Function score is a summation of questions 1,2,3,4, and 15. This study is assessing their erectile function and not the other subscales. The other subscale scores are : 1. Orgasmic Function (Questions 9, 10); Maximum score = 10, Minimum score = 0 2. Sexual Desire (Questions 11, 12); Maximum score = 10, Minimum score = 0 3. Intercourse Satisfaction (Questions 6, 7, 8); Maximum score = 15, Minimum score = 0 4. Overall Satisfaction (Question 13, 14): Maximum score = 10, Minimum score = 0 Subscales are not combined to make a total composite score. \*Crossover subjects were added to Experimental Group for analysis\*
Time frame: Baseline (Pre-Treatment Screening Visit) to end of treatment at week 16