Open AccessA short, 8-week course of imiquimod 5% cream versus podophyllotoxin in the treatment of anogenital warts: A retrospective comparative cohort study
Author(s) -
Electra Nicolaidou,
Αντώνιος Κανελλέας,
Stavros Nikolakopoulos,
G. Bezrodnii,
E. Nearchou,
Maria Gerodimou,
Elisavet Papadopoulou-Skordou,
Vassilios Paparizos,
Dimitrios Rigopoulos
Publication year - 2021
Publication title -
indian journal of dermatology, venereology, and leprology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.514
H-Index - 45
eISSN - 0973-3922
pISSN - 0378-6323
DOI - 10.4103/ijdvl.ijdvl_148_19
Subject(s) - podophyllotoxin , imiquimod , medicine , retrospective cohort study , confidence interval , odds ratio , logistic regression , cohort , dermatology , chemistry , stereochemistry
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 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.