Platelet-rich plasma injections safe and feasible treatment for Peyronie’s disease

Platelet-rich plasma (PRP) injections appear to be a safe and feasible approach to treating patients with Peyronie’s disease, according to early research shared in a poster during the 2021 Sexual Medicine Society of North America (SMSNA) Fall Scientific Meeting.1

First author Kevin Chu, MD, a men’s health fellow at the University of Miami, and colleagues reported data at SMSNA for the first 6 patients enrolled in the study. The patients were randomized to PRP or placebo and completed 2 injections.

“The notable finding to be taken from this abstract is that there were no noted adverse effects for patients that received PRP injections. We had thought there would be some patients with mild ecchymosis or penile pain. This, of course, may change as we enroll more patients into the trial, and our sample size gets larger. But from a preliminary standpoint, it appears to be safe to use in patients with Peyronie’s disease,” Chu said in an interview with Urology Times.

Explaining the rationale for their study, Chu et al wrote in their poster that 7.1% of the general population has Peyronie’s disease, with use of intralesional collagenase clostridium histolyticum injection being the only FDA-approved medical therapy. They noted that surgical interventions for the condition include tunica albuginea plication, plaque excision without grafting, or placement of penile prothesis.

“Intervention only occurs once the disease process has entered the chronic, stable phase,” wrote Chu et al, adding, “Additional Peyronie’s disease therapies are needed as current treatment modalities have limited efficacy and considerable side effects.”

The increased use of platelet-derived therapies in other healthcare specialties inspired Chu et al to examine the approach in patients with Peyronie’s disease. The investigators were particularly intrigued by the use of platelet-derived therapies in orthopedics for the potential of healing wounds and regenerating tissue. “As calcified scar plaques are frequently identified in Peyronie’s disease patients, autologous PRP may prove to be a viable treatment for this patient population,” wrote Chu et al.

Accordingly, a double-blind placebo-controlled, single-center, randomized clinical trial was launched at the University of Miami Miller School of Medicine to compare PRP with placebo in patients with Peyronie’s disease. Chu et al’s SMSNA poster shared the outcome from their safety and feasibility review of the initial series of patients recruited to the trial.
This study population included men enrolled at the University of Miami trial site between April and July 2021 and treated with PRP versus placebo. For their review, the investigators evaluated patients for complications and tolerability immediately following PRP injection and at follow-up. Patients’ International Index of Erectile Function (IIEF-5) scores were reviewed prior to and following injections where applicable.

According to Chu, “The take-home message from our findings is that PRP appears to be safe for use in patients with Peyronie’s Disease. We are still very early on in our clinical trial, as we expect to enroll a total of 60 patients into the trial. As the trial is a double-blind, crossover trial, we do not have any current information on the actual efficacy of PRP in Peyronie’s Disease.”

Chu added, “It is important for [urologists] to know that the trial is currently ongoing. We hope to have a better idea of the efficacy of PRP for Peyronie’s Disease in 1 year. Restorative therapies for sexual medicine have hypothesized mechanisms for efficacy, but more robust clinical trials in humans are needed to show their true potential. At the University of Miami, we are running randomized clinical trials on PRP and combination (PRP + shockwave therapy) for sexual medicine ailments.”

Reference

1. Chu K, Masterson, T, Efimenko, I et al. Safety and feasibility of platelet-rich plasma injections for Peyronie’s disease: update from a single-center double-blind placebo-controlled randomized trial. Paper presented at 2021 Sexual Medicine Society of North America Fall Scientific Meeting; October 21-24, 2021; Scottsdale, Arizona. Abstract 179.