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Delayed Dose Collagenase Clostridium Histolyticum (CCH) Protocol for Men With Peyronie's Disease

Delayed Dose Collagenase Clostridium Histolyticum (CCH) Protocol for Men With Peyronie's Disease

Recruiting
18 years and older
All
Phase 4

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Overview

Our team has previously demonstrated efficacy in performing a novel collagenase Clostridium histolyticum (CCH) injection protocol in men who previously failed to achieve a response to an initial 4 series of CCH.

The objective of the current study is to evaluate a protocol that incorporates limited in-office modeling for up to 4 series, followed by up to 2 additional salvage series to determine safety and efficacy compared to historical data.

Participants will receive up to 4 series of CCH injections using our previously published protocol, with mild in-office modeling. CCH injections are given on back-to back days, after which they are counseled to utilize Restorex and sildenafil daily, as instructed. Patients will undergo mild in-office modeling on day 2.

The sexual partners of study participants will also be invited to enroll in the study and will complete non-validated questionnaires detailing their level of support for the patient's treatment.

Description

The current study would prospectively follow 40 men through the following treatment protocol:

  • Men would receive 4 series of CCH injections according to the protocol below, which represents a modified version of our most recently published technique.13
  • Medication administered on back-to-back days
  • Total of 0.9 mg administered with each series, diluted to 0.8 mL
  • Mild in-office modeling performed on treatment day 2 of each series
  • Wraps performed ranging from 2-4 full-time and 2-4 part-time days to minimize bruising
  • Sildenafil 25 mg nightly beginning treatment day 2 until 6 weeks after final injection of the final series.
  • Restorex initiated beginning on post-injection day 3 or as soon as tolerated - 30 min daily, continuing until 6 weeks after final injection of the final series.
  • Note that men may stop sooner if they are satisfied before completing the 4 series.
  • If the patient is not satisfied with outcomes by the end of the 4th series, they would be permitted to enter the 'salvage' phase of the treatment protocol.
  • This would be performed 9-12 months after the 4th series of injections.
  • The technique would be similar to the one noted above with the exception of more aggressive in-office modeling as described in our prior publication and per our ongoing randomized trial.
  • The men would receive up to two additional series per this protocol for a maximum number of cycles being 6 in total.

At the time of initial enrollment, partners of study participants will be invited to enroll in the study and will be administered non-validated questionnaires designed to assess the partner's overall support for the ongoing treatment protocol.

Assessments and study questionnaires will be administered at baseline, with the 1st injection of each series, 6 weeks after completing the 4th series of CCH injections, and 1 year after completion of the final series of CCH injections.

Eligibility

Inclusion Criteria:

  • Men with Peyronie's Disease
  • Older than 18 years old
  • Curvature ≥30 degrees
  • Ability to achieve an erection satisfactory for intercourse with or without phosphodiesterase-5 (PDE5) inhibitors
  • The patient exhibits a palpable plaque consistent with Peyronie's Disease
  • For partners, the only inclusion criteria is being willing to complete a questionnaire

Exclusion Criteria:

  • Prior surgical treatment on the penis (other than circumcision)
  • Prior treatment with CCH injections
  • Any contraindications to CCH - as determined by the PI

Study details
    Peyronie Disease

NCT06649539

Charitable Union for the Research and Education of Peyronie's Disease

5 September 2025

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