Topically applied treatments for external genital warts in nonimmunocompromised patients: a systematic review and network meta‐analysis. (13th December 2019)

• Record Type: Journal Article
• Authors: Jung, J.M.; Jung, C.J.; Lee, W.J.; Won, C.H.; Lee, M.W.; Choi, J.H.; Chang, S.E.
• Is Part Of: British journal of dermatology. Volume 183:Number 1(2020)
• Page Start: 24
• Page End: 36
• Publication Date: 2019-12-13
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.18638
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Selecting a topical treatment from among the numerous topical agents for external genital warts remains challenging without clear evidence. Our aim was to evaluate comparatively the efficacy and safety of topical agents for external genital warts using a network meta‐analysis. We included all randomized controlled trials that evaluated any topically applied treatment for external genital warts. Using the R package netmeta, network meta‐analyses were performed with a frequentist approach. We identified 41 relevant studies comprising 6371 patients. Among conventional agents, podophyllotoxin 0·5% solution (odds ratio 1·94, 95% confidence interval 1·02–3·71) was significantly more efficacious than imiquimod 5% cream for lesion clearance; however, it was associated with a higher overall adverse event rate. Sinecatechins 15% ointment (odds ratio 0·21, 95% confidence interval 0·12–0·34) was significantly less efficacious than imiquimod 5% cream. Idoxuridine, polyhexamethylene biguanide, cidofovir and SB206 showed comparable therapeutic efficacies with conventional therapies. None of the treatments were significantly different from each other with respect to recurrence, patients with severe adverse events, or patients who withdrew because of treatment‐related adverse events. Conventional modalities were efficacious and well tolerated, although each of them had their advantages and disadvantages. Additional efficacy and safety studies are warranted for unconventional agents. Linked Comment: Doiron. Br J Dermatol 2020; 183 :5–6 . Abstract : Linked Comment: Doiron. Br J Dermatol 2020; 183 :5–6 . Plain language summary available online