Double-blind randomized clinical trial of self-administered podofilox solution versus vehicle in the treatment of genital warts

Kirby, Phil; Dunne, Ardeth; King, Dannie H.; Corey, Lawrence

doi:10.1016/0002-9343(90)90424-c

Cited by 79 publications

(53 citation statements)

References 5 publications

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“…208 In a small (19 treatment, 19 control), double-blind, randomized clinical trial of self-administered podophyllotoxin solution versus vehicle in the treatment of genital warts, patients were instructed to administer 0.5% solution or vehicle at home twice daily for 3 consecutive days of each week for 4 weeks. 209 At the end of the 4 week regimen, the treatment group experienced a 94.9% reduction in wart area and 84.1% reduction in wart count as opposed to 7.1% and 2.6% for the vehicle only placebo. This translates into 1.1 patients needed to treat before seeing a significant reduction in wart area due to treatment, and 1.2 patients for wart count.…”

Section: Podophyllinmentioning

confidence: 92%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

295

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Patients and clinicians experience the frustration of cutaneous viral warts caused by infection with the human papilloma virus (HPV).Warts appear in various forms on different sites of the body and include common warts (verruca vulgaris), plane or flat warts, myrmecia, plantar warts, coalesced mosaic warts, filiform warts, periungual warts, anogenital warts (venereal or condyloma acuminata), oral warts and respiratory papillomas. Cervical infection with HPV is now known to cause cervical cancer if untreated. A review of the medical literature reveals a huge armamentarium of wart monotherapies and combination therapies. Official evidence-based guidelines exist for the treatment of warts, but very few of the reported treatments have been tested by rigorous blinded, randomized controlled trials.Therefore, official recommendations do not often include treatments with reportedly high success rates, but they should not be ignored when considering treatment options. It is the purpose of this review to provide a comprehensive overview of the wart treatment literature to expand awareness of the options available to practitioners faced with patients presenting with problematic warts. Warts of the genital tract carry a much more ominous and pernicious threat for women in particular. It has been estimated that up to 70% of sexually active women become infected during their lifetime with human papillomavirus (HPV), the infective agent that causes warts. 3-5 A causal role for HPV infections in cervical cancer has been documented beyond reasonable doubt. HPV DNA is present in virtually all cervical cancer cases worldwide, with it being detected in 99.7% of an international series of cervical cancers by genetic amplification techniques and in 100% of cases as confirmed by histological review. 6,7 Cervical cancer is the most frequent common cancer in developing countries and the second most common cancer in women worldwide. 3 The association between HPV infection and cervical cancer is so strong that HPV is now considered the first positive cause of any human cancer ever identified. 3This raises the level of concerns over HPV prevention, screening and treatment from that of a nuisance condition to that of a major public health concern. Attention is beginning to focus on the viral factors that determine persistence and neoplastic progression to cancer and the possible role of HPV in other nongenital cancers (e.g., skin, upper aerodigestive tract). [8][9][10][11][12][13][14][15][16][17] Patients with warts seek advice from general practitioners, pharmacists, naturopaths, allied health professionals, family or friends, dermatologists, gynecologists, obstetricians and pediatricians for treatment and may present with recalcitrant warts that have been previously treated with anything from folk remedies to hypnosis to over-the-counter medications to more aggressive clinic-based treatments. Unfortunately, even with years of medical literature on this subject, high-quality, level I evidence for the efficacy of almost all treatments is no...

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Section: Podophyllinmentioning

confidence: 92%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

295

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“…9,10 This study was undertaken to evaluate a new formulation, 0.5% podofilox gel, in the treatment of perianal warts as well as external genital warts for a period of up to 8 weeks.…”

Section: Commentmentioning

confidence: 99%

“…The efficacy of the 0.5% podofilox gel appears similar to that reported for the solution. [9][10][11][12] For example, after 4 weeks of therapy, the mean wart area was reduced by 4.2% or 7.1% in the vehicle solution groups and 82.3% or 94.9% in active drug recipients. 5,6 These figures compare with 4-week data from the current gel study that showed a mean wart surface area increase of 1.3% in the vehicle group and a wart surface area decrease of 73.7% in the 0.5% podofilox gel recipients.…”

Section: Commentmentioning

confidence: 99%

Safety and Efficacy of 0.5% Podofilox Gel in the Treatment of Anogenital Warts

Tyring

Edwards²,

Cherry³

et al. 1998

Arch Dermatol

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“…Odsetek wyleczeń przy stosowaniu podofilotoksyny przez 3-6 tygodni wynosi 43-83% [8,[11][12][13]. Wydaje się, że skuteczność leczenia jest niższa u kobiet.…”

Section: Metody Lecznicze Do Stosowania Samodzielnegounclassified

“…Wydaje się, że skuteczność leczenia jest niższa u kobiet. Nawrotowość zmian jest stosunkowo duża i w różnych doniesieniach wynosiła od kilku do nawet 100% w ciągu 8-21 tygodni po wyleczeniu [8,11,12]. Większość pacjentów doświadcza objawów niepożądanych w postaci pieczenia, bolesności, zmian rumieniowych i nadżerkowych, zwłaszcza w okresie, w którym brodawki ulegają martwicy.…”

Section: Metody Lecznicze Do Stosowania Samodzielnegounclassified

Anogenital warts – the new treatment options

Salomon¹,

Szepietowski²

2014

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STRESZCZENIEKłykciny kończyste to łagodne zmiany proliferacyjne w okolicy anogenitalnej, powstałe w wyniku infekcji wirusem brodawczaka ludzkiego (ang. human papilloma virus -HPV). Brodawki płciowe to najczęstszy kliniczny objaw zakażenia HPV. W ponad 95% przypadków kłykcin koń-czystych znajdowane są typy 6 i 11 HPV, których obecność nie wiąże się z podwyższonym ryzykiem wystąpienia kancerogenezy. W niektó-rych przypadkach brodawek płciowych potwierdza się współwystę-powanie typów HPV uznawanych za onkogenne. Istnieje wiele metod leczenia kłykcin kończystych, jednak żadna z nich nie daje gwarancji, że nie będzie nawrotu zmian. Dostępne metody można podzielić na takie, które pacjent może przeprowadzać samodzielnie w warunkach domowych, oraz na te wykorzystywane tylko w lecznictwie ambulatoryjnym. Do leków stosowanych samodzielnie należą podofilotoksyna, imikwimod oraz najnowsza opcja terapeutyczna -sinekatechina. Jest to preparat będący silnym przeciwutleniaczem, związkiem działającym antyproliferacyjnie, immunomodulująco i mającym właściwości przeciwnowotworowe i przeciwwirusowe. Dokładny mechanizm działania w leczeniu kłykcin kończystych nie jest znany. Skuteczność sinekatechiny w terapii brodawek okolicy anogenitalnej wykazano w trzech wieloośrodkowych, randomizowanych badaniach klinicznych przeprowadzonych w bardzo dużej grupie pacjentów. We wszystkich badaniach stwierdzono bardzo mały odsetek nawrotów. Tolerancja stosowanego leczenia była dobra. W Polsce zarejestrowano preparat sinekatechiny w postaci maści o stęże-niu 10%. Maść aplikuje się na brodawki 3 razy dziennie aż do całkowite-go ustąpienia wykwitów. Maksymalny czas leczenia wynosi 16 tygodni. Do metod terapii stosowanych ambulatoryjnie zalicza się: krioterapię, aplikację kwasu trójchlorooctowego i metody chirurgiczne. ABSTRACTAnogenital warts are hyperproliferating skin changes resulting from human papilloma virus (HPV) infection. This is the most common clinical manifestation of this infection. In over 95% of cases, HPV types 6 and 11 are isolated from the lesions, which are not regarded to be oncogenic types, but in some patients coexistence of oncogenic types of HPV is observed. There are many treatment modalities that are used to treat anogenital warts, but none of them prevents relapses. The available therapeutic methods may be used by the patient at home or may be performed in outpatient care units. The home options are podophyllotoxin, imiquimod and sinecatechin. Sinecatechin, the newest topical agent, is an antioxidant with antiproliferative, immunomodulatory, antiviral and anticancer properties. The efficacy of sinecatechin was proved in SŁOWA KLUCZOWE: kłykciny kończyste, brodawki płciowe, sinekatechina, leczenie, HPV.

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Double-blind randomized clinical trial of self-administered podofilox solution versus vehicle in the treatment of genital warts

Cited by 79 publications

References 5 publications

An Armamentarium of Wart Treatments

An Armamentarium of Wart Treatments

Safety and Efficacy of 0.5% Podofilox Gel in the Treatment of Anogenital Warts

Anogenital warts – the new treatment options

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