Genital Warts Treatments - Factors involved in clearance of Genital Warts
Clinical trial by: Wilson JD, Brown CB, Walker PP.
Department of Genitourinary Medicine, The General Infirmary at Leeds, Great
George Street, Leeds LS1 3EX, UK.ÿ PMID: 11779368 [PubMed - indexed for MEDLINE]
Consecutive patients with first presentation of external anogenital warts had
the location, duration at presentation, number of warts and wart area, age,
smoking and sun bed use, and presence of coexistent sexually transmitted
infections (STIs) recorded. The number of treatment episodes, and number of
weeks, to clear the warts were documented. Number of warts and wart area at
presentation were associated with time and number of treatments to clear. Those
with 1-3 warts required significantly fewer treatment episodes and less time to
clear than those with 11-41 warts, as did those with warts area 2-19 mm(2)
compared with wart area 100-1038 mm(2). Using survival analysis, the number of
warts was significant for the number of treatments and weeks to clear. The
hazard ratio for clearance with double the number of warts after 4 treatments
was 0.53 (95% confidence interval [CI] 0.37-0.76), and at 4 weeks was 0.70
(0.45-0.86). The clearance rates in non-smokers compared with smokers were
higher, but not significantly different. Wart burden at presentation is an
indicator of time to clearance. The number of warts is the best predictor -
fewer warts results in earlier clearance.
Summary:This clinical trial shows that it is important to treat genital warts at the first sign of an outbreak.
Genital Warts Treatments - How often do the Genital Warts recur after treatment?
Depending upon the treatment used, different recurrence rates have been noted. The most common treatment currently used is a self-applied, 5% imiquimod cream (AldaraR) that stimulates the immune system to fight off the virus and lesions. It seems to have a genital wart recurrence rate of about 13-19% (
5, 6, 7).
Sometimes large condyloma are just cut off under local anesthesia with a knife or scissors. This seems to have a recurrence rate of about 21% (
8
). In a study using self-applied podofilox gel, the cure rate was low at only 51% but the recurrence rate was only about 10% (
9
). With respect to the cryotherapy you describe, the recurrence rate is quite high at the level of 73% without any supplemental treatment being given to the cryotherapy (
10). Thus while you may have failed other treatments, the current cryotherapy treatment you are receiving seems to be the least efficacious.
Information credited to Woman's Diagnostic Cyber
and Frederick R. Jelovsek, MD.
