Can tamoxifen and a pde5 inhibitor slow the progression of peyronie's disease?

• Published in: Journal of sexual medicine Vol. 19; no. 11; pp. S15 - S16
• Main Authors: Megson, Matthew, Merrett, Christopher, Ilg, Marus, Cellek, Prof. Selim, Ralph, Prof. David
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.11.2022
• ISSN: 1743-6095; 1743-6109
• DOI: 10.1016/j.jsxm.2022.08.158

The available treatments for peyronie's disease (PD) as recommended by international guidelines are limited to surgery or intralesional injection therapy. We have recently shown that a combination of a phosphodiesterase type 5 inhibitor (PDE5i) and a selective oestrogen receptor modulator (tamoxifen) inhibited myofibroblast transformation and extracellular matrix production in a synergistic manner in in vitro and in vivo. The aim of this study was to compare the combination of tamoxifen and a PDE5i against no treatment or vitamin E in the progression of early peyronie's disease. The data was collected retrospectively from patients with early PD, defined as less than 6 months duration or persistent pain. Patients were given off-label tamoxifen 20 mg twice daily + tadalafil 5 mg daily for 2 months in a private hospital setting. The control group consisted of patients with early PD who either received no treatment or vitamin E in non-private hospital setting. Data retrieved included demographics, duration of disease, change in curvature and pain, as well as further treatment modalities. The curvatures were assessed using photos or an artificial erection test. Data were analysed using the Mann-Whitney test. A total of 147 patients were included with early PD, 102 patients (median age 49, range 24-71) received the combination of tamoxifen and tadalafil and 45 patients (median age 55, range 27-76) received either no treatment or vitamin E. The results in each group are presented in Table 1. Overall, the patients on combination of tamoxifen and tadalafil showed more improvement and less deterioration which was statistically significant (p=0.009) We have previously shown that the combination of tamoxifen and tadalafil prevented PD in vitro and in vivo. This is the first clinical study to demonstrate the efficacy of this combination in slowing down the progression of PD. Future prospective randomised and controlled studies are warranted to confirm this finding. None