Treatment of anogenital warts

Handley, J.; Dinsmore, W W

doi:10.1111/j.1468-3083.1994.tb00361.x

Cited by 8 publications

(4 citation statements)

References 91 publications

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“…This could be confirmed by the 20-30% rate of spontaneous remission during the first year of infection among otherwise healthy patients, and, on the other hand by the extensive refractory disease observed among immunosuppressed patients [28,29]. Conventional treatments for genital warts, including physical or chemical ablation of warts, may cause local issues such as inflammation, pain, ulceration or scars [30].…”

Section: Discussionmentioning

confidence: 99%

Interferon for the treatment of genital warts: a systematic review

Yang

Zeng

et al. 2009

BMC Infect Dis

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BackgroundInterferon has been widely used in the treatment of genital warts for its immunomodulatory, antiproliferative and antiviral properties. Currently, no evidence that interferon improves the complete response rate or reduces the recurrence rate of genital warts has been generally provided. The aim of this review is to assess, from randomized control trials (RCTs), the efficacy and safety of interferon in curing genital warts.MethodsWe searched Cochrane Sexually Transmitted Diseases Group's Trials Register (January, 2009), Cochrane Central Register of Controlled Trials (2009, issue 1), PubMed (1950-2009), EMBASE (1974-2009), Chinese Biomedical Literature Database (CBM) (1975-2009), China National Knowledge Infrastructure (CNKI) (1979-2009), VIP database (1989-2009), as well as reference lists of relevant studies. Two reviewers independently screened searched studies, extracted data and evaluated their methodological qualities. RevMan 4.2.8 software was used for meta-analysisResults12 RCTs involving 1445 people were included. Among them, 7 studies demonstrated the complete response rate of locally-used interferon as compared to placebo for treating genital warts. Based on meta-analysis, the rate of Complete response of the two interventions differed significantly (locally-used interferon:44.4%; placebo:16.1%). The difference between the two groups had statistical significance (RR 2.68, 95% CI 1.79 to 4.02, P < 0.00001). 5 studies demonstrated the complete response rate of systemically-used interferon as compared to placebo for treating genital warts. Based on meta-analysis, the rate of Complete response of the two interventions had no perceivable discrepancy (systemically-used interferon:27.4%; placebo:26.4%). The difference between the two groups had no statistical significance (RR1.25, 95% CI 0.80 to 1.95, P > 0.05). 7 studies demonstrated the recurrence rate of interferon as compared to placebo for treating genital warts. Based on meta-analysis, the recurrence rate of the two interventions had no perceivable discrepancy(interferon 21.1%; placebo: 34.2%). The difference between the two groups had no statistical significance (RR0.56, 95% CI 0.27 to 1.18, P > 0.05). However, subgroup analysis showed that HPV-infected patients with locally administered interferon were less likely than those given placebo to relapse, but that no significant difference in relapse rates was observed between systemic and placebo. The reported adverse events of interferon were mostly mild and transient, which could be well tolerated.ConclusionInterferon tends to be a fairly well-tolerated form of therapy. According to different routes of administration, locally-used interferon appears to be much more effective than both systemically-used interferon and placebo in either improving the complete response rate or reducing the recurrence rate for the treatment of genital warts.

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Section: Discussionmentioning

confidence: 99%

Interferon for the treatment of genital warts: a systematic review

Yang

Zeng

et al. 2009

BMC Infect Dis

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“…Both on day 22 and month 2, the number of CRs resulting from treatment with 33,000 IU r-hIFN-beta was not significantly different from placebo. However, there was a strong dose-response relationship across the three treatments.…”

Section: Resultsmentioning

confidence: 76%

“…The comparison between the three treatment groups of the reduction in area of the lesions on day 22 The treatment was well tolerated, the mc common adverse events were flu-like sym] toms. They were in general transient and mil…”

Section: Resultsmentioning

confidence: 99%

Randomised double-blind trial of recombinant interferon-beta for condyloma acuminatum.

Monsonégo

Cessot

İnce

et al. 1996

Sexually Transmitted Infections

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Objective: To evaluate the safety and efficacy of two intralesional doses of recombinant human interferon-beta (r-hIFN-beta: Rebif X, Ares Serono), given 3 times a week for 3 weeks, in the treatment of condyloma acuminatum. Design: A randomised, double-blind, within-patient, placebo-controlled study. Subjects: 25 patients (24 males, 1 female) with a history of condyloma acuminatum. Twenty had failed previous treatment for condyloma acuminatum. In each patient, 3 distinct lesions were selected for treatmnent. Each selected lesion was randomly assigned to receive intralesionally one of the following: r-hIFN-beta 33,000 lU/day, r-hIFN-beta 1 x 106 IU/day, or matching placebo. Setting: Institut Alfred Fournier, Paris, France. Outcome measures: Response was evaluated colposcopically at the end of treatment (day 22) and 5 weeks later (month 2). Complete response (CR) was defined as disappearance of the treated lesion. Partial response (PR) was defined as at least a 50% reduction in size, but not disappearance of the treated lesion. Results: The higher dose of 1 x 106 IU achieved significantly more complete and partial remissions than placebo, both by the end of treatment, and 5 weeks later. Conclusions: r-hIFN-beta appears to be safe and effective when administered intralesionally to patients with condyloma acuminatum. Most of the treated patients had failed previous treatments and were therefore a resistant population.

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“…This is suggested by the 20± 30% rate of spontaneous remission during the ® rst year of infection among otherwise healthy patients 5,6 , and, on the other hand by the extensive, refractory disease observed among immunosuppressed patients 7 . Conventional therapy for genital condylomata acuminata includes local destruction of warty tissue by podophylotoxin, trichloroacetic acid, cryosurgery, electrical cautery or laser vaporization 5 . Although these measures usually succeed in clearing visible disease in most patients, recurrences are frequent 7,8 , probably as a result of persistent subclinical viral infection.…”

Section: Introductionmentioning

confidence: 94%

Recombinant human interferon- for condylomata acuminata: a randomized, double-blind, placebo-controlled study of intralesional therapy

Bornstein¹,

Pascal²,

Zarfati³

et al. 1997

Int J STD AIDS

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To assess the efficacy of a novel glycosylated mammalian cell derived recombinant human interferon-beta (r-hIFN-beta-1a) in the intralesional treatment of genital condylomata acuminata. The study was randomized, double-blind and placebo-controlled. Patients (n=60) with up to 8 distinct condylomata acuminata were randomized to receive either one million international units (IU) of r-hIFN-beta-1a or placebo intralesionally into each lesion, 3 times a week, for a total of 9 occasions. Biopsies were taken from each patient before enrolment to allow human papillomavirus (HPV) testing, and patients were tested for the development of anti-IFN-beta antibodies. Efficacy was assessed by measuring the complete response rate 3 months after treatment. The complete response rate was not significantly better with r-hIFN-beta-1a than with placebo. However, after 3 months, 73.3% of patients treated with r-hIFN-beta-1a had experienced at least a partial response to treatment, compared with 33.3% of placebo-treated patients. At 19 days and 6 weeks, r-hIFN-beta-1a produced a significantly larger reduction in the area of condylomata. Lesions with detectable HPV6 or 11 showed a trend towards a better response rate to treatment with r-hIFN-beta-1a than lesions where no HPV DNA was detected. The treatment was well tolerated. In the 5 patients who developed non-neutralizing anti-IFN-beta antibodies, therapeutic efficacy was not compromised. Intralesional r-hIFN-beta-1a was effective in the reduction of the size of genital condylomata acuminata.

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Treatment of anogenital warts

Cited by 8 publications

References 91 publications

Interferon for the treatment of genital warts: a systematic review

Interferon for the treatment of genital warts: a systematic review

Randomised double-blind trial of recombinant interferon-beta for condyloma acuminatum.

Recombinant human interferon- for condylomata acuminata: a randomized, double-blind, placebo-controlled study of intralesional therapy

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