Intralesional immunotherapy for the treatment of warts: A network meta-analysis - 14/03/19
Abstract |
Background |
Without clear evidence, selecting among the existing immunotherapeutic options for warts remains challenging.
Objective |
Through network meta-analyses, we aimed to evaluate the comparative efficacy of different intralesional immunotherapeutic modalities.
Methods |
We included randomized controlled trials comparing intralesional immunotherapeutic modalities to cryotherapy, placebo, or imiquimod. All outcomes were presented as odds ratios (ORs) with 95% confidence intervals. Both conventional and network meta-analyses (with a frequentist approach) were conducted on R software. The P-score was used to rank different treatments.
Results |
Network meta-analysis of 17 randomized controlled trials (1676 patients) showed that PPD (purified protein derivative vaccine, OR 39.56), MMR (measles, mumps, rubella vaccine, OR 17.46) and interferon β (OR 15.55) had the highest efficacy in terms of complete recovery at the primary site compared with placebo. Regarding complete recovery at the distant site, autoinoculation (OR 79.95), PPD (OR 42.95), and MMR (OR 15.39) were all statistically superior to placebo. According to the P-score, MMR was more effective than other modalities in reducing the recurrence rate at the same site.
Limitations |
Relatively small sample size in some comparisons and variability in baseline characteristics.
Conclusion |
PPD and MMR were the most effective in achieving complete primary and distant recovery (along with autoinoculation for distant recovery) and reducing the recurrence rate at the same site compared with cryotherapy and other immunotherapeutic modalities.
Le texte complet de cet article est disponible en PDF.Key words : cryotherapy, HPV, immunotherapy, network meta-analysis, warts
Abbreviations used : CI, HPV, INF, MMR, Mw, NMA, OR, PPD, RCT
Plan
Funding sources: None. |
|
Conflicts of interest: None disclosed. |
Vol 80 - N° 4
P. 922 - avril 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?