A comparison of a 5% potassium hydroxide solution with a 5‐fluorouracil and salicylic acid combination in the treatment of patients with anogenital warts: a randomized, open‐label clinical trial

Abstract

Anogenital warts are caused by human papillomavirus (HPV), over 30 types of which are infectious for the anogenital tract. Without treatment, warts may regress spontaneously, remain unchanged, or increase in number and size. This study compared the efficacy of a topical 5% potassium hydroxide (KOH) solution with that of a topical 0.5% 5‐fluorouracil (5‐FU) and 10% salicylic acid (SA) combination in the treatment of anogenital warts. Sixty patients were randomly assigned to receive topical KOH or 5‐FU + SA. Both groups demonstrated a significant decrease in numbers of lesions (P < 0.05), but this difference was not significant at week 12 (P > 0.05). The mean number of lesions decreased from baseline to week 12 from 17.03 ± 12.64 to 3.73 ± 7.30 and from 16.13 ± 12.97 to 3.10 ± 4.90 in the KOH and 5‐FU + SA groups, respectively (P < 0.001). Excellent clearance was achieved by 70.0 and 76.7% of patients in the KOH and 5‐FU + SA groups, respectively. Marked improvement was seen in 13.3 and 20.0% of patients in the KOH and 5‐FU + SA groups, respectively. At week 16, relapse was observed in two patients in the KOH group and three in the 5‐FU + SA group (P > 0.05). No serious adverse events were reported. Neither treatment was more efficacious. Safety and ease of application are important goals in treatments for anogenital warts. A 5% KOH solution is a promising alternative treatment because it is effective and inexpensive and causes minimal side effects.

Randomised controlled trial of 1% and 5% 5-fluorouracil creams compared with 90% trichloroacetic acid solution for anogenital wart treatment

“…As physician-applied treatments are more invasive and more expensive, both physician and patients primarily prefer patient-applied treatment. 12 5-FU is the only patient-applied treatment that might be available in Indonesia; it has already known to be useful for genital warts but currently 5-FU has been overlooked as an option for genital warts. 8 5-FU is a cytotoxic pyrimidine antimetabolic analogue, which plays a role in the S cycle; therefore, it can inhibit DNA synthesis via thymidylate synthetase.…”

Local Management of Anogenital Warts in Non-immunocompromised Adults: A Systematic Review and Meta-analyses of Randomized Controlled Trials

“…However, no differences in recurrence were found between the two treatments. Lastly, no differences were found between 5-FU and KOH (one RCT; n = 60) [34] or between 5-FU and podophyllin 20–25% (one RCT; n = 42) [59], except for the fact that podophyllin 20–25% caused less erosion than 5-FU.…”

“…While no differences in clearance were found between KOH and cryotherapy (one RCT; n = 27) [24] or between KOH and 5-FU (one RCT; n = 44) [34], KOH was shown to cause less erythema and pain than cryotherapy.…”

Terapi kondiloma akuminata menggunakan asam trikloroasetat 80% dan kalium hidroksida 10% pada seorang lelaki yang berhubungan seksual dengan lelaki

“…Romiti et al mendapatkan efektivitas yang sama antara KOH 5% dengan KOH 10%, hanya saja efek iritasi didapatkan lebih ringan pada larutan KOH5%. 8,9,[18][19][20] Rekurensi pada KA biasanya terjadi pada 3 bulan pertama setelah pengobatan. Pasien sebaiknya secara rutin memperhatikan timbulnya lesi baru atau kekambuhan.…”

“…Pemeriksaan HRA memiliki sensitivitas 90%, spesifisitas rendah (19,23%), dengan positive predictive value 41,67% dan negative predictive value 75%. 13,[17][18][19][20][21] Pada kasus telah dilakukan pemeriksaan HRA dan tidak ditemukan kondiloma akuminata intraanal maupun tanda-tanda displasia.…”