Imiquimod para el tratamiento de verrugas anogenitales en adultos no inmunocomprometidos (revisión sistemática)

Abstract. Objectives: To assess the effectiveness and safety of imiquimod for the treatment of AGW in non-immunocompromised adults. Methods: We searched the Cochrane STI Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, among other sources. RCTs comparing the use of imiquimod with placebo, any other patient-applied or any other provider-administered treatment for the treatment of AGW in non-immunocompromised adults. Three review authors independently assessed trials for inclusion, extracted data and assessed risk of bias. We resolved any disagreements through consensus. Results: Ten RCTs (1734 participants) met our inclusion criteria of which six were funded by industry. We judged the risk of bias of the included trials as high. Six trials compared the use of imiquimod versus placebo. There was very low quality evidence that imiquimod was superior to placebo in achieving complete and partial regression (RR 4.03, 95% CI 2.03 to 7.99; RR 2.56, 95% CI 2.05 to 3.20, respectively) and frequency of systemic adverse reactions (RR 0.91, 95% CI 0.63 to 1.32) were imprecise. Two trials compared the use of imiquimod versus any other patient-applied treatment (podophyllotoxin and podophyllin). The estimated effects of imiquimod on complete regression (RR 1.09, 95% CI 0.80 to 1.48), partial regression (RR 0.77, 95% CI 0.40 to 1.47), recurrence (RR 0.49, 95% CI 0.21 to 1.11) or the presence of local adverse reactions (RR 1.24, 95% CI 1.00 to 1.54) were imprecise (very low quality evidence). Two trials compared imiquimod with any other provider-administered treatment (ablative methods and cryotherapy). There was very low quality of evidence that imiquimod did not have a lower frequency of complete regression (RR 0.84, 95% CI 0.56 to 1.28). Conclusions: The benefits and harms of imiquimod compared with placebo should be regarded with caution due to the risk of bias, imprecision and inconsistency for many of the outcomes we assessed.

• Autores: Salazar Díaz, Luis Carlos
• Fecha de publicación: 2014
• Institución: Universidad Nacional de Colombia
• Repositorio: Universidad Nacional de Colombia
• Idioma: spa
• OAI Identifier: oai:repositorio.unal.edu.co:unal/54113
• Acceso en línea: https://repositorio.unal.edu.co/handle/unal/54113; http://bdigital.unal.edu.co/48944/
• Palabra clave: 61 Ciencias médicas; Medicina / Medicine and health; 62 Ingeniería y operaciones afines / Engineering; Randomized controlled trials; Anogenital warts; Sexually Transmitted Infections; Review; Meta-Analysis; Imiquimod; Ensayo clínico; Condiloma acuminado; Infección de transmisión sexual; Revisión; Metanálisis
• Rights: openAccess
• License: Atribución-NoComercial 4.0 Internacional