Evaluation of a combination of off-label PDE5 inhibitor and tamoxifen in acute Peyronie’s disease

Peyronie’s disease (PD) is a fibrotic disease of the penis affecting the tunica albuginea. Prevalence rate in the general population is reported to range between 0.3% and 13.1%. The etiology of PD remains unknown, though proposed contributing factors include microtrauma causing an exaggerated local inflammatory response that leads to fibrotic changes and eventual curvature. PD is characterized by two phases: the acute or unstable phase when the patients present with pain or discomfort during erection, minimal curvature and some early plaque formation followed by the chronic or stable phase. In the chronic phase, the plaque is fully formed and hardened, pain has usually resolved, and erectile dysfunction and penile deformity can be observed. Currently the available treatments recommended by international guidelines are either surgery or local injection therapy which are aimed at those patients in the chronic phase. For patients presenting during the acute phase, there are no approved safe and efficacious treatment options to prevent progression of the disease.