Active Peyronie's disease as an early antifibrotic treatment window: a translational review
Abstract
Abstract Introduction Peyronie’s disease (PD) is an acquired fibrotic disorder of the tunica albuginea that can cause pain, curvature, deformity, erectile dysfunction, and substantial psychosexual burden. Management is usually guided by disease phase, yet active disease remains inconsistently defined, and no oral regimen has shown high-certainty disease-modifying efficacy. We synthesize clinical, mechanistic, guideline, outcome-measure, traction, and public-data evidence relevant to active or progressive PD as a target for early antifibrotic trials. Methods We conducted a targeted narrative translational review of full-text sources on active-phase definitions, PDE5 inhibitor/selective estrogen receptor modulator (SERM) pharmacology, tadalafil-based clinical studies, placebo-controlled tamoxifen evidence, current recommendations, non-surgical evidence reviews, patient-reported outcome measures, traction therapy, and PD transcriptomic or single-cell studies. We selected sources through targeted database searching, citation chasing, and full-text evidence audit; no protocol-registered systematic review was performed. Clinical studies were heterogeneous and largely non-randomized; therefore, we did not attempt a pooled efficacy estimate. Results Active and stable PD remain clinically useful categories, although their operational definitions vary across studies. Experimental PD models identify fibroblast-to-myofibroblast transformation as a pharmacologically accessible process,…
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