What are your thoughts on the upcoming collagenase injections that are supposed to be marketed in 2007-2008? Why weren’t these injections pushed before, it seems like verapamil was the hot PD drug for injections and now you are hearing more and more about collagenase. What are your predictions on the efficacy of this type of treatment or feasibility?

Collagenase is an enzyme which breaks down collagen which is the primary component of the Peyronie’s plaque. Studies using collagenase began in the 1980s. These showed some benefit but not necessarily dramatic benefit in the early studies that were done at that time. Unfortunately because of lack of funding, the company who owned the drug was unable to complete the necessary trials to demonstrate true clinical benefit. More recently, a company has purchased the rights to that drug and is planning to pursue FDA approval for the use of collagenase for Peyronie’s disease. The protocol is currently in development and to my knowledge, no collagenase injections are being given anywhere. I am sure that once the studies begin there will be notification on this website so that interested parties may determine whether they are candidates for the clinical trials. The overall concept is to use the collagenase much like a “chemical knife” to literally dissolve the scar tissue and hope that the tissue will remodel in such a fashion to reduce the deformity caused by the scar. We will need to wait and see on the outcomes from the trials before making further conclusions. Verapamil still appears to be the most sensible injection therapy for PD.