2023
DOI: 10.1002/ijgo.14953
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The efficacy of topical imiquimod in high‐grade cervical intraepithelial neoplasia: A systematic review and meta‐analysis

Abstract: ObjectiveA major side effect of cervical excision for high‐grade cervical intraepithelial neoplasia (CIN) is premature birth. A non‐invasive treatment for reproductive age women is warranted. The aim of the present study was to determine the efficacy of topical imiquimod in the treatment of high‐grade CIN, defined as a regression to ≤CIN 1, and to determine the clearance rate of high‐risk human papillomavirus (hr‐HPV), compared with surgical treatment and placebo.MethodsDatabases were searched for articles fro… Show more

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Cited by 7 publications
(6 citation statements)
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“…Comparing the efficacy of imiquimod to standard large loop excision a recent meta-analysis confirms the superiority of surgical excision in HSIL (OR: 14.81, 95% CI 6.59-33.27), 89 with a response rate of 37%-63% in imiquimod treated versus 92.3%-94% for large loop excision. Furthermore, the authors reported an HR-HPV clearance rate of 53.4% after imiquimod treatment and 66% after surgical excision (95% CI 0.62-23.77).…”
Section: Cervical Intraepithelial Neoplasiamentioning
confidence: 90%
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“…Comparing the efficacy of imiquimod to standard large loop excision a recent meta-analysis confirms the superiority of surgical excision in HSIL (OR: 14.81, 95% CI 6.59-33.27), 89 with a response rate of 37%-63% in imiquimod treated versus 92.3%-94% for large loop excision. Furthermore, the authors reported an HR-HPV clearance rate of 53.4% after imiquimod treatment and 66% after surgical excision (95% CI 0.62-23.77).…”
Section: Cervical Intraepithelial Neoplasiamentioning
confidence: 90%
“…Imiquimod dose was 6.25 mg for vaginal suppository, 70 while those using imiquimod cream used either a half-sachet dose (6.25 mg) 74 up to a full sachet of Imiquimod 5% cream (12.5 mg). 72,89 Only one study 69 Several randomized controlled trials evaluated the role of imiquimod cream for CIN treatment: the first, compared a vaginal 6.25 mg imiquimod suppository for 14 weeks to a placebo in 69 CIN 2-3 untreated patients. 70 Histological complete remission was reported in 47% in the imiquimod arm and 14% in the placebo group (p-value = 0.008), while overall regression (defined as histologic regression to CIN1 or less at 20 weeks) in 73% versus 39%…”
Section: Cervical Intraepithelial Neoplasiamentioning
confidence: 99%
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“…For this reason, alternative conservative methods for SIL treatment are constantly being evaluated, and imiquimod (IMQ), a synthetic tolllike receptor 7 (TLR7) agonist, has generated attention for its potential to stimulate local antitumor and antiviral immune responses. Although studies have shown that IMQ is effective for treating vulvar intraepithelial neoplasia (VIN) [3], vulvar Paget disease [4], vaginal intraepithelial neoplasia (VaIN) [5], and CIN when compared to placebo or no intervention [6], its exact mechanism of action remains unclear [7].…”
Section: Introductionmentioning
confidence: 99%