Impact of Race and Ethnicity on Clinical Outcomes of Collagenase Clostridium histolyticum in Patients With Peyronie's Disease Across Kaiser Permanente Southern California Database.

Abstract

Introduction: Intralesional collagenase Clostridium histolyticum (CCH) injection is an effective intervention for treatment of Peyronie's disease (PD). While CCH efficacy has been demonstrated in White populations, little is known about treatment efficacy in Black and Hispanic populations.

Methods: This study examined efficacy of intralesional CCH in a racially diverse population in a large integrated health care system over 15 years. Treatment efficacy was defined as percent change in penile curvature abnormality from baseline after up to 4 treatment cycles.

Results: Of the 112 patients with PD who underwent CCH therapy, 66.1% of men were White, 22.3% were Hispanic, and 9.8% were Black. Additionally, 63.4% of men had a baseline penile curvature of 30°-59°. There were no significant differences in treatment response to CCH across different racial and ethnical groups (P = .96). There was a statistically significant difference in number of cycles completed across different ethnicities (P = .022). When adjusted for completing a full 4-cycle treatment, the Hispanic subgroup had the most patients complete fewer than 4 cycles (P = .0004). Almost half of the Hispanic subgroup (48%) reported needing an interpreter for health appointments.

Discussion: This is the largest postmarket analysis of CCH treatment outcomes in a racially diverse PD population. Though there were no significant differences in treatment outcomes by race and ethnicity, Hispanic men were significantly less likely to complete 4 cycles of injection therapy. One possible explanation is a language barrier, which prevented future follow-up treatment.

Conclusion: The use of CCH treatment for PD is an effective option for racially diverse patient populations.