快樂小藥師 Im pharmacist nichts glücklich

Peyronie’s disease is characterized by a plaque or hard lump that occurs on the penis.

病名來源是一位法國醫師François Gigot de La Peyronie (1678-1747)

她是法國路易士十五世時代的皇家內科醫生，他首先科學地描述了此病，故此病以其名而命名。

It begins as a localized inflammation, which progresses to a hardened scar that reduces flexibility and causes the penis to bend during erection. This causes pain on erection and in some circumstances may prevent sexual intercourse altogether. Aside from the physical consequences, depression and loss of self-esteem are common in men with Peyronie’s disease. It is currently believed that Peyronie’s disease is caused by vascular trauma or injury to the penis. Peyronie’s disease is most common in men over 50 years, and the incidence increases with age.

Generally, Peyronie’s disease is treated by urologists. There are no approved drug therapies for Peyronie’s disease. Surgical treatment may be an option for some patients, although complications as well as loss of penile length can occur. Xiaflex is injected intralesionally into the affected area in an in-office procedure with the intent to soften the scar tissue and reduce the curvature of the penis. This is expected to improve sexual function and minimize the negative psychosocial aspects of the disease.

Clinical Trial Results

The first phase II trials, sponsored and monitored by BioSpecifics Technologies Corp., licensor of Xiaflex, with follow up and data analysis conducted by Auxilium, showed promising results. Both studies were open label and up to 12 months in duration. The trials were conducted to evaluate the efficacy and tolerability of Xiaflex in the treatment of Peyronie's disease. Clinical success was defined as change from baseline in deviation angle of at least 25%.

In Study A (n=25), three injections of Xiaflex, each administered on a separate day, were given over seven to ten days. Patients received a second series of three injections 12 weeks later. Patients were evaluated at three, six, and nine months post-last injection. The mean baseline deviation angle was 52.8°. With respect to deviation angle, clinical success was achieved at three and six months with 58% and 53% of patients, respectively.

The best results were achieved with a three-treatment series of three injections each in Study B (n=10). In Study B, patients received three injections of Xiaflex administered one per day, separated by at least one day each, over a one-week timeframe. Patients received two additional series of three injections, each spaced six weeks apart. The mean baseline deviation angle was 50.2°. At nine month follow up (post-first injections), 25% or greater reduction in deviation angle was achieved in eight out of nine patients who completed the study (89%, 1 patient had 24% reduction in deviation angle). Based on the investigator's global assessment, 67% of subjects were very much improved or much improved after treatment with Xiaflex.

The most common adverse events reported in both studies were local administration site reactions that were mild or moderate in severity, non-serious, and resolved in time without medical attention.

佩洛尼氏病或是帕榮雷氏病，講白話一點就是陰莖海綿體硬結症

治  療
發病早期，使用一些藥物可能會緩解病情。可是，病情發展到最後，並且對於嚴重的病例，唯一有效的治療措施是外科手術。儘管如此，在施行手術之前，明智的做法是等上一年或兩年，因為病症也許不久會未治而自愈。同理，只要性交仍然能夠維持，並且陰莖彎曲程度不大，簡單地進行性生活的調節並避免外科手術也許是明智之舉。

所以現在有幾種藥物可以考慮：

1.Xiaflex，妳可能對這個藥物很陌生，她是一個溶組織芽胞梭菌膠原酵素注射劑，不過他也可以用在Dupuytren氏孿縮症(Dupuytren's contracture)的治療。（應該更陌生了，沒關係，我改天會找機會告訴大家）

2.考慮另類療法：

PABA 1-3g 每天4次 x 3-12個月
維他命E  400-1600iu/day x 6個月以上

或是DHEA，但是確實效果很難說。