verapamil intralesional / Stada - LARVOL DELTA

Comparison of Intralesional Triamcinolone Versus Verapamil for Keloid Treatment (clinicaltrials.gov) - P4 | N=60 | Not yet recruiting | Sponsor: Nishtar Medical University

New P4 trial • Fibrosis • Immunology

Contemporary nonsurgical management of Peyronie's disease. (PubMed, Curr Opin Urol) - "Herein, we will discuss notable advances in nonsurgical management of Peyronie's disease."

Clinical • Journal • Review • Urology • IFNA1

A review of Peyronie's disease insurance coverage. (PubMed, Sex Med) - "Peyronie's disease (PD) is a fibroproliferative disorder that causes an abnormal curve of the penis resulting in pain, discomfort, and erectile dysfunction with management options including correctional surgery, penile external/internal devices, shock wave therapy (SWT), intralesional Verapamil (IV), and collagenase Clostridium histolyticum injections. Finally, this study only addressed some of the common treatment options of PD and did not expand on all possible treatment options. Differing rates for modalities of treatment may present a barrier for patients to receive individualized and adequate treatment for PD."

Journal • Reimbursement • Review • US reimbursement • Erectile Dysfunction • Pain

Intralesional injection of hyaluronic acid compared with verapamil in acute phase of Peyronie's disease: A prospective randomized clinical trial. (PubMed, Arab J Urol) - "The decrease in penile curvature at 12 weeks after therapy was noticeably better in group A in contrast to group B (24.7 ± 9.72° vs. 30.8 ± 8.63°, p = 0.038). HA is emerging as a valid choice for the treatment of PD in terms of resolution of the acute phase of the disease, and it is plausible to posit that the use of HA may contribute to the stabilization of the disease and decrease the need for the subsequent choice of a possible surgical strategy, with the ability to reduce penile pain and have a stronger impact on penile curvature and patient satisfaction."

Clinical • Journal • Pain

Our Experience at Tertiary Medical College-Intralesional Injection of Triamcinolone Acetonide Versus Injection Verapamil Following Keloidectomy with Fillet Flap in Auricular Keloids. (PubMed, Indian J Otolaryngol Head Neck Surg) - "A recurrence rate of 14.28% was found in 4 of 28 keloids at 12 months postoperatively. The Patient and Observer Scar Assesment Scale scores (POSAS scores) were consistently higher than Beausang scores at 1 year, indicating high patient satisfaction compared to physician assessment in both groups A and B. A keloid recurrence-free interval of 11.36 months was obtained by the Kaplan-Meier survival test (p < 0.05) in group A. Keloid recurrence-free interval of 10.98 months was evaluated by the Kaplan-Meier survival test (p < 0.05) in group B. Among Keloidectomy with fillet flap surgery with intralesional injection of triamcinolone acetonide (group A) and keloidectomy with fillet surgery with intralesional injection of verapamil (group B), at each follow-up the success rate of group B was higher than group A indicating better trend of success in this group in terms of both absence of recurrence and absence of complications without statistically..."

Journal • Fibrosis

Comparative Efficacy of Drug Interventions for Keloids: A Network Meta-analysis. (PubMed, Ann Plast Surg) - "Botulinum toxin A and TAC plus 5-FU appear to have outstanding therapeutic efficacy for keloids. The rate of adverse events was similar among BTA, TAC, 5-FU, and TAC plus 5-FU. Nonetheless, additional reviews of rigorous, large-scale randomized controlled trials are warranted for further validation of our findings."

Clinical • Journal • Retrospective data • Review • Fibrosis

Comparing intralesional triamcinolone and verapamil-triamcinolone injections in keloids: A single-blinded randomised clinical trial. (PubMed, Int Wound J) - "These findings suggest that the combination of verapamil and triamcinolone provides a more effective treatment for keloids, thereby highlighting the potential of verapamil in scar reduction."

Journal • Fibrosis

Bevacizumab as adjuvant therapy in the treatment of keloid: A randomized clinical trial (EADV 2023) - "Intralesional triamcinolone has been established as an effective corticosteroid treatment for keloids, while sporadic reports suggest the efficacy of intralesional verapamil. Our study demonstrates that bevacizumab can be considered an effective and safe adjuvant therapy option for keloid treatment, suggesting its potential as a promising treatment for the management of keloids."

Clinical • Fibrosis

Recurrence rates in the treatment of keloids and hypertrophic scars with intralesional triamcinolone combined with other intralesional agents. (PubMed, Arch Dermatol Res) - "In the treatment of pathologic scar, combination approaches using intralesional agents, such as triamcinolone (TAC), 5-fluorouracil (5FU), verapamil (VER), bleomycin (BLM), and botulinum toxin (BTX), are superior therapies when compared to monotherapy (Yosipovitch et al., J Dermatol Treat 12(2):87-90. There are limitations to this review in that comparisons were made across studies with varying outcome variables, including scar size, injection concentration and interval, and follow-up period. Standardized follow-up periods and recurrence rate reporting are integral to furthering the understanding of these therapies and enhancing patient care."

Journal • Review • Fibrosis

Medical Treatment for Peyronie's Disease: Systematic Review and Network Bayesian Meta-Analysis. (PubMed, World J Mens Health) - "At present, there is no clinical treatment alternatives that have been demonstrated to be effective compared to placebo. Nonetheless, as the frequentist approach has shown that a number of agents are efficacious, further research is expected to develop more effective treatment options."

Journal • Retrospective data • Review • Erectile Dysfunction • Fibrosis

Ledderhose’s disease treated with intralesional injections of corticosteroids (EADV-Sp 2023) - "The treatment of this rare disease receives relatively little. Other than steroids, a wide variety of nonsurgical options exist such as radiation therapy, antiestrogen,Verapamil and Collagenase .Many of these treatment options are promising, but require further studies of sufficient size and power."

Fibrosis • Genetic Disorders • Idiopathic Arthritis • Immunology • Pain • Rare Diseases • Rheumatology • Solid Tumor

Intralesional Hyaluronic Acid and Verapamil Injection in Peyronie's Disease (clinicaltrials.gov) - P=N/A | N=42 | Not yet recruiting | Sponsor: Benha University

New trial • Fibrosis

Understanding the Effects of Actinidin as a Collagenase acting to treat Human Peyronie’s Disease Cells (AUA 2023) - "Intralesional injection of collagenase Clostridium histolyticum is the only FDA approved treatment for PD, however, is no longer available in Canada...The cells were plated on a 96-well plate and treated with their respective treatments: media, saline, verapamil, actinidin at 50, 25 and 10 mg/ml for 24 hours... Our preliminary study suggests the possible effects of actinidin in breaking down PD plaques by compromising the extracellular matrix, membrane-bound proteins, and the cellular membrane of human PD fibroblasts. An increased level of normalized actin in the high concentration actinidin group acts suggests a compromised plasma membrane and a potential mechanism of action. Further studies will investigate the optimal actinidin concentration that can safely reduce the collagen composition of human PD plaques."

Erectile Dysfunction • Fibrosis • Pain • Rheumatology • Urology

Keloid treatments: an evidence-based systematic review of recent advances. (PubMed, Syst Rev) - "This review was limited by heterogeneity of subject characteristics and study outcome measures, small sample sizes, and inconsistent study designs. Larger and more robust controlled studies are necessary to further understand the variety of existing and emerging keloid treatments, including corticosteroids, cryotherapy, intralesional injections, lasers, photodynamic therapy, excision and radiation, pressure dressings, and others."

Journal • Review • Fibrosis

Commentary: A Primer on the History of Intralesional Verapamil Injection for Peyronie's Disease. (PubMed, Urology) - No abstract available

Journal • Fibrosis

A systematic review of non-surgical management in Peyronie's disease. (PubMed, Int J Impot Res) - "Of the intralesional treatments, Collagenase Clostridium Histolyticum showed evidence for improving penile curvature (Range: 16.3-17 degrees, moderate level certainty of evidence). Intralesional Interferon demonstrated some improvement in curvature (Range: 12-13.5 degrees), plaque size (Range: 1.67-2.2 cm) and pain, whilst intralesional calcium channel blockers such as Verapamil showed variable evidence for changes in the plaque size and pain...Intralesional options demonstrate the best potential. Overall, results varied with few high-quality randomised trials present."

Journal • Review • Fibrosis • Pain

Laser therapy for treating hypertrophic and keloid scars. (PubMed, Cochrane Database Syst Rev) - "Laser versus other treatments: We are uncertain whether treatment with 585-nm PDL impacts on hypertrophic and keloid scar severity compared with intralesional corticosteroid triamcinolone acetonide (TAC), intralesional Fluorouracil (5-FU) or combined use of TAC plus 5-FU (very low-certainty evidence)...Other comparisons included 585-nm PDL versus silicone gel sheeting, fractional CO laser versus TAC and fractional CO laser versus verapamil...Due to the heterogeneity of the studies, conflicting results, study design issues and small sample sizes, further high-quality trials, with validated scales and core outcome sets should be developed. These trials should take into consideration the consumers' opinion and values, the need for long-term follow-up and the necessity of reporting the rate of recurrence of scars to determine whether lasers may achieve superior results when compared with other therapies for treating hypertrophic and keloid scars."

Journal • Review • Aesthetic Medicine • Dermatology • Fibrosis • Immunology • Pain

Intralesional collagenase Clostridium histolyticum vs. verapamil injections in males with Peyronie's Disease: A prospective, matched-pair, non-blinded, randomised clinical study comparing clinical outcomes and patient satisfaction rates. (PubMed, Investig Clin Urol) - "CCH therapy is more effective than ILV to treat a carefully selected group of males with PD, with a reasonable safety profile and a higher high level of patient satisfaction rate in the short term."

Clinical data • Journal • Fibrosis

Excision and adjuvant treatment to prevent keloid recurrence. - a systematic review of prospective, clinical, controlled trials. (PubMed, J Plast Surg Hand Surg) - "Adjuvant treatment methods included intralesional triamcinolone injection, radiotherapy, silicone gel, pressure therapy, verapamil hydrochloride and 5-fluorouracil. While all the included studies reported promising results, two studies showed that minimizing dosages when treating with radiotherapy or triamcinolone should be considered to avoid adverse events. However, a high risk of bias was found in all the included studies."

Journal • Review • Fibrosis

Cost of Intralesional Collagenase Clostridium Histiolyticum Therapy Versus Surgery for the Management of Peyronie's Disease: A Claims-Based Analysis (2009-2019). (PubMed, Sex Med) - "CCH use has increased significantly since its FDA approval in 2013 with out-of-pocket patient contribution comparable to surgical therapy despite significantly higher total treatment costs. Walton EL, Quinn TP, Mulloy E, et al. Cost of Intralesional Collagenase Clostridium Histiolyticum Therapy Versus Surgery for the Management of Peyronie's Disease: A Claims-Based Analysis (2009-2019). Sex Med 2022;XX:XXXXXX."

Journal • Fibrosis

Treatment of Keloids: A Meta-analysis of Intralesional Triamcinolone, Verapamil, and Their Combination. (PubMed, Plast Reconstr Surg Glob Open) - "When comparing the modalities of triamcinolone acetonide and verapamil for keloid treatment, triamcinolone acetonide shows more significant and rapid improvement compared with verapamil; however, there are also increased adverse effects. Minimal combination studies of these treatments have shown that perhaps using them together can augment their mechanisms without the unwanted side effects."

Journal • Retrospective data • Fibrosis

Assessment of Conservative Combination Therapies for Active and Stable Peyronie's Disease: A Systematic Review and Meta-analysis. (PubMed, Eur Urol Focus) - "The available combination treatment modalities, including the addition of adjunctive mechanical therapies to CCH, do not improve symptoms further compared with monotherapy and should not be implemented in patients with active or stable PD. Further high-quality randomized trials combining only recommended treatments are mandatory."

Combination therapy • Journal • Retrospective data • Review • Fibrosis

Network Meta-Analysis of Different Clinical Commonly Used Drugs for the Treatment of Hypertrophic Scar and Keloid. (PubMed, Front Med (Lausanne)) - "Randomized clinical trials evaluating different treatment strategies of pathological scars, including triamcinolone acetonide (TAC), verapamil (VER), 5-fluorouracil (5-FU), botulinum toxin A (BTA), bleomycin (BLM), and silicone gels were included in the study. But for patients who cannot tolerate the side effects, the use of silicone gels in combination with TAC is recommended. However, these conclusions need to be further confirmed by more randomized controlled trials."

Clinical • Retrospective data • Review • Fibrosis

Novel treatments for keloid scars. (PubMed, Clin Exp Dermatol) - "We read with interest the article by Dr Naik which reviews novel targets and therapies for keloids (1). Dr Naik discussed the use of botulinum toxin A, intralesional verapamil and the potential use of novel miRNA modulation.We believe that the author might have overlooked the use of 5-fluorouracil (5-FU) and the use of laser assisted drug delivery as emerging therapies."

Journal • Fibrosis • Immunology

A comparison of intralesional verapamil and triamcinolone monotherapy in the treatment of keloids in an African population. (PubMed, Niger J Clin Pract) - "However, verapamil injection was comparably effective to triamcinolone for small-size keloids. Verapamil as monotherapy is less efficaceous in the resolution of symptoms of keloids but is comparable to triamcinolone in reducing the size of small-sized keloids."

Clinical • Journal • Monotherapy • Dermatology • Fibrosis • Pain • Pruritus • Thermal Injury