A systematic review evaluating the efficacy and safety of acombination of ablative treatment and self administered treatment versus ablative treatment alone for external anogenital warts.

Abstract

External anogenital warts are proliferative lesions. Till now, there is no consensus on the standard treatment of external anogenital warts. The combination of ablative therapy and self-administered treatment has been reported to achieve sustained complete clearance than ablative therapy. The aim of this review was to compare the efficacy on achieving complete clearance of warts between the combination of ablative therapy with self-administered therapy and ablative therapy alone. We conducted a systematic review to evaluate the efficacy and safety of the combination of ablative therapy and self-administered treatment for external anogenital warts. The Cochrane Central Register of Controlled Trials, Medline, Embase and Science Citation Index Expanded, China National Knowledge Infrastructure and Wanfang were searched. Of 1138 initially identified publications, 37 studies in English and Chinese were included. The combination of ablative therapy and self-administered treatment therapy showed significantly high complete clearance rates at 4, 8, 12, or 24weeks after treatmentcompared to ablative therapy alone. In a subgroup analysis based on the treatment duration of imiquimod cream therapy, 4 and 8weeks of imiquimod 5% cream plus CO2 laser produced similar efficacy on clearance. The combination therapy is tolerable for patients. In conclusion, this review provided evidence to support the use of the combination of ablative therapy and self-administered treatment for external anogenital warts to maintain sustained clearance.