TY - JOUR
TI - A short, 8-week course of imiquimod 5% cream versus podophyllotoxin in
the treatment of anogenital warts: A retrospective comparative cohort
study
AU - Nicolaidou, Electra
AU - Kanelleas, Antonios
AU - Nikolakopoulos, S. and
AU - Bezrodnii, G.
AU - Nearchou, E.
AU - Gerodimou, M. and
AU - Papadopoulou-Skordou, E.
AU - Paparizos, V
AU - Rigopoulos, D.
JO - Indian Journal of Dermatology, Venereology, and Leprology
PY - 2021
VL - 87
TODO - 5
SP - 666-670
PB - SCIENTIFIC SCHOLAR LLC
SN - 0378-6323, 0973-3922
TODO - 10.4103/ijdvl.IJDVL_148_19
TODO - Anogenital warts; comparison; human papillomavirus; imiquimod;
podophyllotoxin
TODO - Background: Studies comparing head-to-head treatment modalities for
anogenital warts are lacking.
Aim: We sought to compare a short, 8-week course of imiquimod 5% cream
to versus the standard 4 week course of podophyllotoxin in the treatment
of anogenital warts and to assess factors that may affect response to
treatment.
Methods: This was a retrospective cohort study. We reviewed medical
files of otherwise healthy patients with a first episode of anogenital
warts who were treated with either a short, 8-week course of imiquimod
or the standard 4-week course of podophyllotoxin. Inverse probability of
treatment weighted (IPTW). Logistic regression was employed to evaluate
factors that may affect response to therapy.
Results: The study included 347 patients. In patients with lesions on
dry, keratinized anatomical sites, the complete clearance rates were
7.6% for imiquimod and 27.9% for podophyllotoxin (P < 0.001). In
patients with lesions on moist, partially keratinized sites, no
difference between the treatments was revealed. Significant predictors
of > 50% reduction in wart area were location of lesions [odds ratio
(OR) (95% confidence interval (CI)): 3.6 (1.84-7.08), P = 0.0002] for
“partially keratinized” versus “keratinized” sites and treatment
used [OR (95% CI): 1.79 (1.08-2.97), P = 0.024] for podophyllotoxin
versus imiquimod.
Limitations: The retrospective design of the study was a limitation that
we mitigated against with the use of IPTW logistic regression.
Conclusion: A standard 4 week course of Podophyllotoxin was more
effective than an 8-week course of imiquimod only for lesions on
keratinized sites. Treatment with podophyllotoxin and location of
lesions on partially keratinized sites were independent predictors of
>50% reduction in wart area.
ER -