Warts (genital)

Overview

Abstract | Cite as | Substantive changes

Abstract

INTRODUCTION: External genital warts (EGWs) are sexually transmitted benign epidermal growths caused by the human papillomavirus (HPV), on the anogenital areas of both females and males. About 50% to 60% of sexually active women aged 18 to 49 years have been exposed to HPV infection, but only 10% to 15% will have genital warts. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for external genital warts? What are the effects of interventions to prevent transmission of external genital warts? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 55 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: bi- and trichloroacetic acid; condoms; cryotherapy; electrosurgery; imiquimod; intralesional, topical, or systemic interferons; laser surgery; podophyllin; podophyllotoxin; surgical excision; and vaccines.

Cite as

Jr HWB. Warts (genital). Clinical Evidence 2010; 08:1602.

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Substantive changes

Interferon (topical) One systematic review (search date 2009) added.[18]No new data added to benefits or harms. Categorisation unchanged (Beneficial).

Interferon (intralesional) One systematic review (search date 2009) added. [18]No new data added to benefits or harms. Categorisation unchanged (Unknown effectiveness).

Interferon (systemic) One systematic review (search date 2009) added, which included five RCTs and pooled data.[18] Benefits and harms data enhanced. The review found no significant difference between systemic interferon and placebo in complete response rate or recurrence rate. Categorisation unchanged (Likely to be ineffective or harmful).

Vaccines One systematic review added (search date 2007), which included two large RCTs using quadrivalent vaccine, which reported on a composite outcome of external genital disease and pooled data. [57]The review found that quadrivalent vaccine significantly reduced external genital disease (including warts as part of a composite outcome) compared with placebo. Five further reports added to comments as background information.[61][62][63][64][65] Categorisation of vaccines (quadrivalent) changed from Likely to be beneficial to Beneficial.

Latest citations

Imiquimod for anogenital warts in non-immunocompromised adults. ( 17 December 2014 )

5-FU for genital warts in non-immunocompromised individuals. ( 18 September 2014 )