Self-reported Clinical Meaningfulness Early in the Treatment Course Predicts Objective Outcomes in Men Undergoing Collagenase Clostridium histolyticum Injections for Peyronie Disease.

Autor: Ziegelmann MJ; Department of Urology, Mayo Clinic, Rochester, MN., Viers BR; Department of Urology, Mayo Clinic, Rochester, MN., Montgomery BD; Department of Urology, Mayo Clinic, Rochester, MN., Westerman ME; Department of Urology, Mayo Clinic, Rochester, MN., Savage JB; Department of Urology, Mayo Clinic, Rochester, MN., Trost LW; Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: trost.landon@mayo.edu.
Jazyk: angličtina
Zdroj: Urology [Urology] 2017 Aug; Vol. 106, pp. 107-112. Date of Electronic Publication: 2017 May 05.
DOI: 10.1016/j.urology.2017.04.045
Abstrakt: Objective: To compare perceived meaningfulness early in the course of collagenase Clostridium histolyticum (CCH) with final outcomes to evaluate its use as a predictor of efficacy.
Materials and Methods: A registry of patients undergoing CCH from March 2014 to September 2016 was maintained. Patients were recommended to complete 4 injection cycles. After each cycle, patients completed a questionnaire that included, "If you stopped at this point, would you consider this a meaningful improvement for you?" Curve assessments were performed before and at therapy completion. Analyses were performed to compare objective curve changes and reported meaningfulness.
Results: Complete information was available on 52 patients, including 79% who reported meaningful results. Median improvement (interquartile range) was 25 degrees (15;35) in the meaningful (+) group compared with 5 degrees (0;15) in the meaningful (-) group (P = .0007). When stratified by perception early during therapy, patients who found the second series meaningful experienced a greater final curve improvement (P = .005). More than 50% of patients with curvature improvements of ≥10 degrees or ≥10% found the therapy meaningful. Among men with ≤5-degree improvement after 2 series, 83% (5/6) experienced further curve improvements (median 20 degrees). Interestingly, 50% of patients with improvement ≤10 degrees reported meaningfulness, including 40% without objective improvement.
Conclusion: Objective curve outcomes can be stratified by early subjective clinical meaningfulness with CCH, and the majority of patients with ≥10-degree or ≥10% curve improvement found CCH meaningful. Men failing to achieve objective curve benefits after 2 series experience further curve improvements in the majority of cases.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: