@article{3125692,
    title = "Efficacy of 5% imiquimod for the treatment of Vaginal intraepithelial neoplasia—A systematic review of the literature and a meta-analysis",
    author = "Tranoulis, A. and Laios, A. and Mitsopoulos, V. and Lutchman-Singh, K. and Thomakos, N.",
    journal = "European Journal of Obstetrics and Gynecology and Reproductive Biology",
    year = "2017",
    volume = "218",
    pages = "129-136",
    publisher = "Elsevier Ireland Ltd",
    doi = "10.1016/j.ejogrb.2017.09.020",
    keywords = "imiquimod;  aminoquinoline derivative;  antineoplastic agent;  imiquimod, abdominal pain;  application site excoriation;  cancer recurrence;  cancer therapy;  Cochrane Library;  diarrhea;  drug efficacy;  drug withdrawal;  Embase;  female;  fever;  flu like syndrome;  health care quality;  human;  Medline;  meta analysis;  non invasive procedure;  priority journal;  randomized controlled trial (topic);  recurrence risk;  Review;  systematic review;  tumor diagnosis;  vaginal intraepithelial neoplasia;  viral clearance;  adult;  intravaginal drug administration;  papillomavirus infection;  retrospective study;  treatment outcome;  uterine cervix carcinoma in situ;  vagina tumor;  virology;  young adult, Administration, Intravaginal;  Adult;  Aminoquinolines;  Antineoplastic Agents;  Cervical Intraepithelial Neoplasia;  Female;  Humans;  Papillomavirus Infections;  Randomized Controlled Trials as Topic;  Retrospective Studies;  Treatment Outcome;  Vaginal Neoplasms;  Young Adult",
    abstract = "Vaginal intraepithelial neoplasia (VaIN) is an uncommon disease associated with HPV and is considered to be a precursor of vaginal carcinoma. To date, treatment recommendations vary with no universally accepted standard of care as best treatment modality. Nevertheless, 5% imiquimod appears to be a promising, alternative, non-invasive treatment option. To ascertain the efficacy of 5% imiquimod for the treatment of this rare condition, we conducted a systematic review and meta-analysis of the proportion of women who received 5% imiquimod with their complete response, HPV clearance and recurrence rates. A literature search was carried out throughout the PubMed, EMBASE, ClinicalTrials.gov and Cochrane Databases for relevant studies. We computed the summary proportions for complete response, HPV clearance and non-recurrence following administration of 5% imiquimod by random effects meta-analysis. Six articles reporting on 94 patients were included. The summary proportions of women with complete response and HPV clearance were 76.5% (95% CI 59.4–98.5) and 52.5% (95% CI 29.5–93.6) respectively. The summary proportion of women with non-recurrence appeared high (94.3% (95% CI 67.1–132)), yet not significant. Use of 5% imiquimod for the treatment of VaIN is associated with relatively high response rate, satisfactory HPV clearance, whilst the risk for VaIN recurrence appears low. © 2017"
}