Predictors of treatment success after collagenase Clostridium histolyticum injection for Peyronie's disease: development of a nomogram from a multicentre single-arm, non-placebo controlled clinical study

Objective: To build a nomogram able to predict treatment success after collagenase Clostridium histolyticum (CCH) for Peyronie's disease (PD). Materials and Methods: Between November 2016 and November 2017, we enrolled 135 patients with PD into a multicentre single-arm prospective study. All patients enrolled received CCH treatment. Success of therapy was defined as a decrease in penile curvature (PC) of ≥20° from baseline. Treatment satisfaction was assessed using a scale from 1 to 10, and high satisfaction was arbitrarily defined as a score of ≥8. Calcification level was classified as: absence of calcification; low perilesional calcification; and high calcification. Results: The median (interquartile range [IQR]) patient age was 56.0 (45.0–65.0) years and the median (IQR) was PC was 30 (30.0–60.0)°. After the treatment protocol, we observed a significant median change in PC of −20.0° (P <0.01). The median (IQR) PC improvement was 44 (28.0–67.0)%. Overall median (IQR) satisfaction score was 8.0 (7.0–9.0). Treatment efficacy was reported in a total of 77 patients (57.04%). When analysing factors associated with PC improvement after treatment, we found that baseline PC (odds ratio [OR] 1.14; P <0.01), basal plaque (OR 64.27; P <0.01), low calcification (OR 0.06; P <0.01) and high calcification (OR 0.03; P <0.01) were significant predictors of PC improvement. The c-index for the model was 0.93. Conclusions: Patients with longer PD duration, greater baseline PC and basal plaque location had a greater chance of treatment success. These results could be applied to clinical practice before external validation of our nomogram. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd