Pentoxifylline is not an approved Peyronie’s disease drug

There are several things I find interesting in a question and answer about Peyronie’s disease and Pentoxifylline (Pentox) I discovered online recently.  It appears on the Peyronie’s forum of a medical doctor who is well known as a Peyronie’s disease expert.  I will not use the doctor’s name since it does not serve a useful purpose to mention his name.

Here is the question, followed by the doctor’s answer:

Question:  Can Pentoxifylline help with increasing blood flow when a man has PD?  Also is Niacin also an alternative that might achieve any results?

Answer:   Pentoxifylline has been shown in animal studies to potentially reduce the development of the Peyronie’s scar when the animals consumed the Pentox in their drinking water from the time that the Peyronie’s process is triggered.  Pentoxifylline is indicated to enhance blood flow to the lower extremities in patients with peripheral vascular disease likely because it has a mild non-specific vasodilating effect.  Therefore, it is possible that it can increase blood flow in the man with PD.  As to whether this will improve erections or has anything to do with preventing progression of already established PD is unknown.  Niacin, to my knowledge, has not been studied as a treatment for Peyronie’s disease.

Pentox preferred simply because it is a drug

Point # 1.  The doctor responds that the use of Pentoxifylline is used to treat Peyronie’s disease because it has the ability to enhance blood flow to the lower extremities in patients with peripheral vascular disease likely because of its mild non-specific vasodilating effect.

My response:  Here the doctor is saying that Pentoxifylline is used in Peyronie’s disease because it improves blood flow in people who have peripheral vascular disease.  Anyone who has studied this subject knows that Peyronie’s disease is not a vascular or blood vessel disease, so it is difficult to understand from this answer the connection between the two conditions. This reason he gives for using Pentox for treatment of PD is not supported by what we know about this condition.

Point #2.  The doctor states that Pentoxifylline is used in Peyronie’s disease (of the penis) because it improves blood flow in the periphery of the body, meaning arms and legs.

My response:  These are two different areas of the body. This part of the answer suggests that Pentox has not been tested or shown to actually improve the blood flow to the penis, only the upper and lower extremities.  This reason he gives for using Pentoxifylline for treatment of PD is not supported by what we know about this condition.

Point #3.  The doctor attempts to tie his two points together and then carefully speculates that “it is possible that it can increase blood flow in the man with PD.”

My response:  What the doctor is saying is that using Pentox for Peyronies treatment might possibly work since it works for other conditions that are only remotely related. This kind of speculative use of a drug is common, and would not be objectionable except for the fact that Pentoxifylline is known to have side effects that can affect the cardiovascular, immune, digestive, respiratory, visual and nervous systems. That is a risk taken by a patient for use of a drug that might only possibly help an unrelated condition.  I doubt many patients know that they are exposing themselves by taking drugs that are not known to help the condition they have.

Point #4.  The doctor reports that it is unknown if Pentoxifylline will improve erections or has anything to do with preventing progression of an existing case of Peyronie’s disease.

My response:   Saying that it is unknown if Pentox will improve erections suggests that it does not influence blood flow to the penis. Yet, improving penile blood flow is one of the reasons given by this doctor to justify using it for Peyronie’s disease.   Since I have never heard of anyone taking any medication for prevention of Peyronie’s disease, the doctor also says that Pentoxifylline will not alter the progression of a case of PD once it has started.  This sounds to me that it would not help Peyronie’s disease.

Point #5.  The doctor reports that to his knowledge niacin (a member of the B vitamin family) has never been studied as a possible treatment for Peyronie’s disease.

My response:  Niacin is well known to those who take vitamins for the “niacin flush” that it causes.  Niacin causes an increased blood flow throughout the body, experienced as heat, redness and itching that occurs after taking a few hundred milligram dose.

So we have the doctor reporting that Pentox (with side effects) is used to treat Peyronie’s disease because it has a “mild non-specific vasodilating effect,” yet niacin (with no side effects) which also has a mild to moderate non-specific vasodilating effect has never been studied as a Peyronie’s treatment.

I think this is a classic example of the drug industry ignoring potential non-drug therapies simply because they lack profitability.  This is a point to remember when you are told that no nutritional therapy has been shown to help PD.   This is only true because these companies refuse to do the testing to prove they might have merit.

Point #6.   The doctor uses  only one brief  sentence to discuss niacin, and 90% of his reply to discuss a drug that does the same thing as niacin can do and do it without side effects.  In his short sentence about niacin he only says that it has not been studied as a Peyronie’s treatment.  Period.  As a scientist, as a physician interested in advancing the body of thought about Peyronie’s treatment, wouldn’t you think the doctor would be more interested in something like niacin?  Instead, he merely brushes the idea of niacin use for PD aside.  This is so typical of the attitude of organized medicine about treatment of Peyronie’s disease.

Point #7.  The man who asked a reasonable and intelligent question about niacin was not given an actual answer about niacin.    He was only given a reply that promoted the use of a drug that has side effects and not known to be effective against Peyronie’s disease.   And you wonder why men get frustrated with the lack of help and useful information about Peyronies treatment.