{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:37:59Z","timestamp":1791999479839,"version":"4.4.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370690"],"award-info":[{"award-number":["82370690"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82303813"],"award-info":[{"award-number":["82303813"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2023MH241"],"award-info":[{"award-number":["ZR2023MH241"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2023QH271"],"award-info":[{"award-number":["ZR2023QH271"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Taishan Scholars Program of Shandong Province","award":["tsqn201909199"],"award-info":[{"award-number":["tsqn201909199"]}]},{"name":"Taishan Scholars Program of Shandong Province","award":["tsqn202306403"],"award-info":[{"award-number":["tsqn202306403"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Peyronie\u2019s disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase Clostridium histolyticum (CCH) is an injectable drug that treats PD by enzymatically degrading plaque interstitial collagen. CCH has been used in patients with varying curvature, as well as in the acute and stable phases of the disease, through a variety of treatment regimens and combinations. We carried out a systematic review and meta-analysis to assess the efficacy of CCH combination therapies for PD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We selected 4 observational comparative studies and 3 randomized controlled trials including 532 participants from the PubMed, Embase, and Cochrane databases (until December 2023) to evaluate the efficacy of CCH combination therapies for PD. The primary outcome was clinical efficacy as evaluated by improvement in penile curvature and penile length, as well as by scores on the Peyronie\u2019s Disease Questionnaire (PDQ) for symptom bother, penile pain, and psychological symptoms. Continuous data were represented by mean difference (MD) and 95% CI. All data were analyzed by Review Manager version 5.3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>For penile length (MD,\u00a00.81\u00a0cm; 95% CI, 0.17-1.45; P\u2009=\u2009.01), PDQ symptom bother (MD,\u00a0\u20131.02; 95% CI, \u20131.83 to \u20130.21; P\u2009=\u2009.01), and PDQ penile pain (MD,\u00a0\u20130.93; 95% CI, \u20131.50 to \u20130.36; P\u2009=\u2009.001), CCH combination therapy showed significantly greater improvements vs CCH monotherapy. However, in the other indicators, penile curvature and PDQ psychological symptoms, there was no significant difference between the therapies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This meta-analysis supports that CCH combination therapies can partially increase penile length and ameliorate symptom bother and penile pain to some extent. However, CCH combination therapies still need to be evaluated through more high-quality research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sxmrev\/qeae025","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T05:52:31Z","timestamp":1713851551000},"page":"497-504","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of collagenase <i>Clostridium histolyticum<\/i> combination therapies for Peyronie\u2019s disease: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"12","author":[{"given":"Yicheng","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiancheng","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongquan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengze","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7924-3923","authenticated-orcid":false,"given":"Jitao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanshan","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Urology, Yantai Yuhuangding Hospital, Qingdao University , Yantai 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"issue":"1","key":"2024070101015859200_ref1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.sxmr.2015.10.002","article-title":"The genetic basis of Peyronie disease: a review","volume":"4","author":"Herati","year":"2016","journal-title":"Sex Med Rev"},{"issue":"1","key":"2024070101015859200_ref2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/sj.ijir.3900635","article-title":"Peyronie\u2019s disease in men under age 40: characteristics and outcome","volume":"13","author":"Tefekli","year":"2001","journal-title":"Int J Impot Res"},{"issue":"1","key":"2024070101015859200_ref3","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/S0022-5347(01)65366-7","article-title":"Mechanisms by which fibrin and fibronectin appear in healing wounds: implications for Peyronie\u2019s disease","volume":"157","author":"Van de Water","year":"1997","journal-title":"J Urol"},{"key":"2024070101015859200_ref4","article-title":"The efficacy and safety of intralesional injection of collagenase Clostridium histolyticum for Peyronie\u2019s disease: a meta-analysis of published prospective studies","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Pharmacol"},{"issue":"9","key":"2024070101015859200_ref5","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/j.jsxm.2019.06.010","article-title":"Comparative cost-effectiveness of surgery, collagenase Clostridium histolyticum, and penile traction therapy in men with Peyronie\u2019s disease in an era of effective clinical treatment","volume":"16","author":"Wymer","year":"2019","journal-title":"J Sex Med"},{"issue":"3","key":"2024070101015859200_ref6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1038\/s41585-018-0117-7","article-title":"Nonsurgical management of Peyronie\u2019s disease","volume":"16","author":"Tsambarlis","year":"2019","journal-title":"Nat Rev Urol"},{"issue":"90","key":"2024070101015859200_ref7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta19900","article-title":"Collagenase Clostridium histolyticum for the treatment of Dupuytren\u2019s contracture: systematic review and economic evaluation","volume":"19","author":"Brazzelli","year":"2015","journal-title":"Health Technol Assess"},{"issue":"3","key":"2024070101015859200_ref8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.eururo.2021.06.007","article-title":"European Association of Urology guidelines on sexual and reproductive health\u20142021 update: male sexual dysfunction","volume":"80","author":"Salonia","year":"2021","journal-title":"Eur Urol"},{"issue":"5","key":"2024070101015859200_ref9","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1097\/JU.0000000000003634","article-title":"Comparison of collagenase Clostridium histolyticum to surgery for the management of Peyronie\u2019s disease: a randomized trial","volume":"210","author":"Green","year":"2023","journal-title":"J Urol"},{"issue":"3","key":"2024070101015859200_ref10","first-page":"e123","article-title":"Preferred Reporting Items for Systematic Reviews and Meta-analyses: the PRISMA statement","volume":"3","author":"Moher","year":"2009","journal-title":"Open Med"},{"key":"2024070101015859200_ref11","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"2024070101015859200_ref12","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"issue":"6","key":"2024070101015859200_ref13","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.jsxm.2019.03.007","article-title":"Efficacy of combined collagenase Clostridium histolyticum and RestoreX penile traction therapy in men with Peyronie\u2019s disease","volume":"16","author":"Alom","year":"2019","journal-title":"J Sex Med"},{"issue":"10","key":"2024070101015859200_ref14","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1016\/j.jsxm.2018.08.012","article-title":"Sildenafil 25 mg ODT + collagenase Clostridium hystoliticum vs collagenase Clostridium hystoliticum alone for the management of Peyronie\u2019s disease: a matched-pair comparison analysis","volume":"15","author":"Cocci","year":"2018","journal-title":"J Sex Med"},{"issue":"6","key":"2024070101015859200_ref15","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1111\/bju.14784","article-title":"Optimizing collagenase Clostridium histolyticum therapy for Peyronie\u2019s disease using a novel approach with percutaneous needle tunnelling","volume":"124","author":"Fern\u00e1ndez-Pascual","year":"2019","journal-title":"BJU Int"},{"issue":"6","key":"2024070101015859200_ref16","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1016\/j.juro.2012.01.032","article-title":"Phase 2b study of the clinical efficacy and safety of collagenase Clostridium histolyticum in patients with Peyronie disease","volume":"187","author":"Gelbard","year":"2012","journal-title":"J Urol"},{"issue":"11","key":"2024070101015859200_ref17","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.jsxm.2017.08.015","article-title":"Treatment of Peyronie\u2019s disease with collagenase Clostridium histolyticum and vacuum therapy: a randomized, open-label pilot study","volume":"14","author":"Ralph","year":"2017","journal-title":"J Sex Med"},{"issue":"6","key":"2024070101015859200_ref18","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1111\/iju.14230","article-title":"Peyronie\u2019s disease: contemporary evaluation and management","volume":"27","author":"Ziegelmann","year":"2020","journal-title":"Int J Urol"},{"issue":"1","key":"2024070101015859200_ref19","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1743-6109.2007.00651.x","article-title":"The use of intralesional clostridial collagenase injection therapy for Peyronie\u2019s disease: a prospective, single-center, non-placebo-controlled study","volume":"5","author":"Jordan","year":"2008","journal-title":"J Sex Med"},{"issue":"4","key":"2024070101015859200_ref20","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/bju.13096","article-title":"Clinical efficacy of collagenase Clostridium histolyticum in the treatment of Peyronie\u2019s disease by subgroup: results from two large, double-blind, randomized, placebo-controlled, phase III studies","volume":"116","author":"Lipshultz","year":"2015","journal-title":"BJU Int"},{"issue":"2","key":"2024070101015859200_ref21","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.36337","article-title":"Assessment of combination therapies vs monotherapy for erectile dysfunction: a systematic review and meta-analysis","volume":"4","author":"Mykoniatis","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"6","key":"2024070101015859200_ref22","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1111\/j.1743-6109.2008.00814.x","article-title":"Penile traction therapy for treatment of Peyronie\u2019s disease: a single-center pilot study","volume":"5","author":"Levine","year":"2008","journal-title":"J Sex Med"},{"issue":"4","key":"2024070101015859200_ref23","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.niox.2003.12.002","article-title":"L-arginine and phosphodiesterase (PDE) inhibitors counteract fibrosis in the Peyronie\u2019s fibrotic plaque and related fibroblast cultures","volume":"9","author":"Valente","year":"2003","journal-title":"Nitric Oxide"},{"issue":"5","key":"2024070101015859200_ref24","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1016\/j.euf.2021.12.003","article-title":"Assessment of conservative combination therapies for active and stable Peyronie\u2019s disease: a systematic review and meta-analysis","volume":"8","author":"Pyrgidis","year":"2022","journal-title":"Eur Urol Focus"},{"issue":"4","key":"2024070101015859200_ref25","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.sxmr.2019.05.001","article-title":"Discontinuation from collagenase Clostridium histolyticum therapy for Peyronie\u2019s disease: review and single-center cohort analysis","volume":"7","author":"Amighi","year":"2019","journal-title":"Sex Med Rev"}],"container-title":["Sexual Medicine Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/smr\/article-pdf\/12\/3\/497\/58335032\/qeae025.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/smr\/article-pdf\/12\/3\/497\/58335032\/qeae025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T01:03:58Z","timestamp":1719795838000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/smr\/article\/12\/3\/497\/7655837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,22]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,4,22]]},"published-print":{"date-parts":[[2024,6,26]]}},"URL":"https:\/\/doi.org\/10.1093\/sxmrev\/qeae025","relation":{},"ISSN":["2050-0513","2050-0521"],"issn-type":[{"value":"2050-0513","type":"print"},{"value":"2050-0521","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,7]]},"published":{"date-parts":[[2024,4,22]]}}}