Tranilast - Japanese drug (omori / toho hospital)

[NeoV]

I'd like to bring this drug to everyone's attention, since it does not seem to have a thread or mention on these forums.

I've been living in Tokyo for about a year, unfortunately my Peyronies progression since coming here has been very challenging. I finally was able to see a specialist at Omori-hospital (the only specialist?), and what I confirmed is that pentox is not available in Japan (ordinarily). Instead they prescribe the Japanese developed drug Tranilast (N(3,4-dimethoxycinnamoyl)anthranilic acid).

Tranilast is known to have a major blocking affect on TGF-beta1. I cannot seem to find any recent studies regarding peyronies, but my urologist assured me he had personally seen many cases of improvement, claiming it should soften up the scar tissue. Here are some general links regarding Tranilast and TGF-beta1. I encourage anyone to read these as well as do some searching on their own. The effect looks promising.

Tranilast prevents activation ... [Arterioscler Thromb Vasc Biol. 2002] - PubMed - NCBI
Inhibitory effects of tranilast on expressio... [Atherosclerosis. 1998] - PubMed - NCBI
Welcome to F1000Prime - F1000Prime
Tranilast attenuates vascular hypertrophy, ma... [Diabetes Metab. 2003] - PubMed - NCBI

I should mention that the drug was originally developed for asthma it seems, but is also used for fibrotic disorders here in Japan. The only side effect that is worth mentioning is a possibility of cystitis, which seems very rare and is reversed after disuse. The uro told me to stop taking it if I had any kind of symptoms.

I cannot say much else about this drug, but rather wanted to bring it to everyone's attention. Japan has a lower prevalence rate of peyronies due to genetics. I have no reason to advocate the drug nor Japan's pharmaceutical industry. I will be taking this for several months, the uro wants to see me in one month. I'll let everyone know my progress.

WARNING AND EDIT - I have stopped taking this drug due to a study below that demonstrated that it increases plaque growth in the brain responsible for Alzheimers by 20 FOLD. Looking back I do not know if it had helped me at all, I highly recommend CoQ10 and Pentox, since the studies are much better on them and they are safe and effective.  

[Jonbinspain]

It's always interesting to hear of any prospective new treatment. Please do keep everybody informed of your progress.

[skunkworks]

This is VERY interesting! Thanks for hte post.

[funnyfarm]

I agree, excellent post, thank you for this info Neo.  For some reason, autoimmune disorders like Peyronies are  less common in Asia.   Some asthma meds, down regulate the immune system (as does pentox) which can potentially reduce or soften scaring.  The good news is the they cause less side effects than pentox.   I think there is a good chance it will help you, there is always the question though of what happens when you stop taking it, do you need to take it indefinitely ?  I wish we knew more about why the immune system becomes unbalanced in the first place, as we could get to the root cause of Peyronies Disease (and all autoimmune diseases).  Time will tell, I wish you the best of luck.  

[skunkworks]

Another poster on the forum was prescribed a similar drug zafirlukast, and saw softening of scar tissue. zafirlukast has been used to successfully treat capsular contracture but its main use is an asthma med. This avenue certainly seems like something that needs a lot more attention.

Please do keep us updated, I will be watching your posts with great interest.

I have a hunch that for those with hourglassing, the softening that these could provide might go a long way toward resolution.

[NeoV]

I agree, excellent post, thank you for this info Neo.  For some reason, autoimmune disorders like Peyronies are  less common in Asia.   Some asthma meds, down regulate the immune system (as does pentox) which can potentially reduce or soften scaring.  The good news is the they cause less side effects than pentox.   I think there is a good chance it will help you, there is always the question though of what happens when you stop taking it, do you need to take it indefinitely ?  I wish we knew more about why the immune system becomes unbalanced in the first place, as we could get to the root cause of Peyronies Disease (and all autoimmune diseases).  Time will tell, I wish you the best of luck.

Thanks so much for the reply, It is frustrating, and the thought of having to take a medication for one's entire life is no fun at all. I would love to use both pentox and tranilast, but I'm still working on finding a way to receive it here. I can only hope that I can improve symptoms enough to stop taking the drug, and then just take extra care from then on not to reactivate the disease. I have seemed to have found a way (several ways) for me to avoid peyronies worsening, so if I can make any improvement, hopefully that will be the end for me. If only there was a way to remove the root cause.. Gene therapy is all I can really imagine, but as you say time will tell.

As far as side effects go, I'm not entirely sure which has worse side effects. I am trying my best to gather information on the cystitis that Tranilast might cause.

I'm currently taking 3 pills a day, and have not felt any negative effects so far. Whereas pentox made me slightly tired, Tranilast does not seem to cause this. I am noticing a kind of slight paraesthesia, or mild sensation throughout my body, mainly hands and legs but also in my penis and prostate area. While I also had something similar with pentox, I did not feel it in my penis area.

Another poster on the forum was prescribed a similar drug zafirlukast, and saw softening of scar tissue. zafirlukast has been used to successfully treat capsular contracture but its main use is an asthma med. This avenue certainly seems like something that needs a lot more attention.

Please do keep us updated, I will be watching your posts with great interest.

I have a hunch that for those with hourglassing, the softening that these could provide might go a long way toward resolution.

That's very interesting, again I wonder what pentox and one of these types of drugs could do for us if taken together. I have a kind of hour glass deformity, which seems to get better the longer I keep my penis harder, and or pump my penis to full capacity manually . I am assuming this is because I am stretching the layer of scar tissue there, so any softening would surely help.

[funnyfarm]

Yes skunk, I took the zafirlukast (accolate) for 3mo beginning in early Dec, and also took pentox for 4mo beginning in early Nov.  The scar softened to the point where I no longer needed the drugs and stopped taking them.   Unfortunately I have been dealing with bad inflammation, but it is my prostate/urethra and not peyronies related.   The good news is that the lump did not get hard again.

I am not sure which drug helped more.  All I can say with certainty is the accolate had no side effects, and I was taking a strong dose of pentox 2000mg/day which did cause anxiety and bad sleep.   And it did lower my white blood cell count, due to immune suppression, but it has since climbed back to the normal range.  So overall I can not complain.

Keep us posted on your progress Neo.  For some of us, I think diet is also an important clue as intestinal dysbiosis and permeability can really stress the immune system.

[NeoV]

UPDATE: Tranilast is no longer giving me any side effects. I have no burning while urinating, and no more anxiety.

Tranilast looks good from everything I'm reading so far. I've been reading more about keloids and Tranilast and have come upon some nice looking studies. This one has some technical information in it.

Here's one more on TGF-beta in keloid scars.
The effects of tranilast on biological active factors production and type Ⅰ/Ⅲ procollagen mRNA expression of keloid fibroblasts - medical research papers

Id also like to mention so far my penis is feeling very good, and a bit softer while hanging better. I am doing manual stretches as well. I will be getting Cialis tomorrow. Apparently, from one study I read, Tranilast takes about 4 weeks to fully enter fibrotic lesions, but this was not a study on the penis, and it was quite old. I am however really looking forward to any further benefit. I am seeing the uro again on the 5th for blood work and a checkup next month.

[james1947]

NeoV

Interesting. Give us an update when you will have improvements. It may help others also.

James

[mmmm]

This seems like an interesting alternative. Any news NeoV? It could be useful if you ask your doctor about the treatment and the results and whether there is some kind of research or information regarding Peyronie that maybe difficult for us to access since it's from Japan. Thanks!

[NeoV]

Hey everyone, time for an update.

I just had my follow up appointment with my uro here in Tokyo after taking Tranilast for just one month along with vitamin E.

It turns out that Omori hospital is the only place in all of Japan that offers surgery for peyronies, as well as the only place really specializing in it. Because of that there are a lot of peyronies patients that go there even here in Japan. I confirmed that even young Japanese men were patients there. When I asked him about the number of patients he used a word meaning "mountains of patients", or a huge amount which was interesting to me.. but it made sense.

My urologist (I am ashamed to not even know his name) was knowledgeable regarding Tom Lue and Dr. Levine. Apparently the main urologist there was a student of Lue's, or something along those lines though I wasn't understanding everything he said.

He told me I should try to get pentox from the US, since Japan may not have it for many years. He also told me that Tranilast takes about 4 months to produce noticeable results. Good to know, since I did happen to read a study about keloids and that it took about a month before the drug had "entered" the scar, or started to make changes upon it.

Finally to get to my actual experience with the drug, I can report at least, that my penis has hung better and at a somewhat new angle since starting Tranilast one month ago. While I doubt one month is sufficient to produce results, I do feel that my penis has simply felt fuller and erections stronger. I am feeling pretty positive about my erections in general since starting this. It just, feels different..

Side effects pretty much disappeared a week after taking the drug. I take 100mg 3x a day along with vitamin E 3x a day.

Today I was given 2 more months worth of the drug. I really don't know what to say other than that my penis is changing again. It really really seems to be for the better. But only time will tell.

mmmm, I am terribly sorry. While I did mention the research on Tranilast I did not get any conclusive response regarding weather or not peyronies and Tranilast had been studied together! I will ask him directly next time at the end of September. I'm sorry about that, I had so many things to say to him I forgot that entirely.

He did however talk to me as if it had not been studied with peyronies. He mentioned keloids again and how after 4 months they get soft, and that eventually they fall off. Research seems to confirm this. I have googled in Japanese for studies on peyronies and Tranilast and came up with nothing, though there are plenty of Japaneses studies on the drug itself, as well as numerous in English on keiloids and other fibrotic disorders.

Sorry for the long winded reply, hopefully it's something to read for all of you at least, and I will be updating regularly and answering any questions any of you have.

-V

[skunkworks]

Yes it is a hugely interesting post and thanks for coming back and updating. Every single piece of information you can get about tranilast is greatly appreciated. So no studies, but would the doctors there be able to shed any light on individual case studies of patients using it? Anonymous of course.

[NeoV]

Skunkworks that is a great suggestion thank you. I wrote that down along with the previous question about studies in my notebook for next time. I will surely report on the answers I get. I did ask him about the drug in general, and his experience during my first visit. At that time he said yes It definitely helps. He seemed very confident. Reading all of the studies I have to say it looks good, if not as good as pentox when it comes to fibrotic disorders, but, one never truly can know without more information.

I will ask him at the end of next month if he can give me more concrete information regarding any individuals who have benefited from Tranilast.

He seems to welcome conversation with me, and that really helps so I'll definitely give it my best shot next meeting!

[George999]

Neo I think it is important to understand that Pentox, as good as it is, is NOT a silver bullet.  Pentox takes a long time to work as well, and it is certainly not a cure.  It helps significantly, that is about as far as it goes.  The same is true of CoQ10.  Of course I believe that CoQ10 and Ubiquinol should be easy to obtain in Japan.  As for Pentox, IF your physician in Japan were willing to provide you with  a prescription, I am sure you could get it via a legitimate mail order source from the US or Canada.  But thank you so much for all that you are sharing with us.  In the case of Peyronie's, all information is extremely valuable, since there is so little to begin with.  We are all so glad to hear that things are improving for you.  That is about as much as you can expect and is about as much as anyone around here has experienced.  We wish you all the best for the future!  - George

[james1947]

NeoV

Your report, as others had said is very important to the forum.
Happy to hear that you have results after one month already.
Just keep us updated, here where I am living easy to get Japanese medications and I am very interested to see your results.

James

[LMP]

Is Tranilast only available in Japan?

[james1947]

I made a google for Tranilast and I get comfused:
http://en.wikipedia.org/wiki/Tranilast
https://www.caymanchem.com/app/template/Product.vm/catalog/13044
Someone can shade some light on the subject?
From the second link:
Warning This product is not for human or veterinary use. Have also distributors search on the page.

James

[NeoV]

It sounds like Tranilast is available in the US, yet I do not know how.

Caymanchem.com sells drugs and other products for the purpose of research only. The same statement is written on all of their product profiles even those that are completely safe. Tranilast is safe and meant for human use, but Caymanchem can't or doesn't sell drugs for that purpose. It may be a legal or just precautionary.

[NeoV]

I think I am done with Tranilast. This 2013 study has scared me far too much.
The study shows that Tranilast promotes the growth of the fibril formations that cause dementia and Alzeimer's. They warn that for those at risk for the disease or elders the results of taking the drug could be "devastating". At my age it may not be worth worrying about but I don't think I can keep taking the drug knowing that I am increasing any fibril formation I may have by 20 fold. I just feel awful now, I don't know what else can be said. I beg any of you, who know about Alzheimer's and Aβ's role in it to give me their opinion on this study. I have stopped using the drug as of today and skipping my next dose at the moment. It looks like these researches purchased the drug from chaymanchem.com interestingly.. I am having a hard time understanding what this really means for me.

http://faculty.neuroscience.ucla.edu/institution/publication-download?publication_id=4180037

"ABSTRACT: The antiallergy and potential anticancer drug tranilast has been patented for treating Alzheimer's disease (AD), in
which amyloid β-protein (Aβ) plays a key pathogenic role. We used solution NMR to determine that tranilast binds to Aβ40
monomers with ∼300 μM affinity. Remarkably, tranilast increases Aβ40 fibrillation more than 20-fold in the thioflavin T assay at
a 1:1 molar ratio, as well as significantly reducing the lag time. Tranilast likely promotes fibrillation by shifting Aβ monomer
conformations to those capable of seed formation and fibril elongation. Molecular docking results qualitatively agree with NMR
chemical shift perturbation, which together indicate that hydrophobic interactions are the major driving force of the Aβ−tranilast
interaction. These data suggest that AD may be a potential complication for tranilast usage in elderly patients."

[George999]

Neo,  If I were you I would not be too worried about this.  The drug has been around for a while and this problem has just now been discovered.  While this drug seems to promote fibrillation, it is highly unlikely that effect would continue once the drug is discontinued AND there are biologic processes whereby that fibrillation can be reversed.  The really important thing is to make sure to have a good diet that includes a lot of vegetables as they tend to help with these issues.  Anything that causes "high cholesterol" is known to promote AD.  So a diet high in vegetables is your friend in this case.  Additionally, this might be a time to explore possible options in regards to Pentox.  - George

[guero]

Hi guys,
I'm from Italy and I need to buy tranilast for a cancer treatment, but I think it is sold only in Japan. How could I get it? James,you said that in Romania is possible to get it,I would be very interested. Otherwise, if I go to Japan do you think I could get a prescription to buy it and bring it to Italy?
Thank you very much
Andrea

[james1947]

No guero, I didn't say can get it in Roamnia.
Please read again the topic and click on the provided links, you may find where to buy.
At the link bellow:
https://www.caymanchem.com/app/template/Product.vm/catalog/13044
click on the Global distributors button will give you (from the flag I understand you are from Italy):
Cabru SAS di Casagrande
Via Forlanini, 52
Arcore
20862
Italy
Voice:   0039-039-601-3988
Fax:   0039-039-601-4284
info@cabru.it
CABRU s.a.s.
Vinci-Biochem Srl
Via Ponte di Bagnolo, 10
Vinci (Fi)
50059
Italy
Voice:   +0571 568 147
Fax:   +0571 568 132
vb@vincibiochem.it
http://www.vincibiochem.it/

James

[yyy]

I'm interested in buying this drug as well

[james1947]

yyy

You have the Italian distributors in the post bellow yours

James

[yyy]

Thanks james but Id need tabs not raw powder. Moreover they only sell to companies