Cantharidin therapy: Practice patterns and attitudes of health care providers

Pompei, David; Rezzadeh, Kameron; Viola, Kate V.; Lee, Diana H.; Schairer, David; Chismar, Larissa A.; Cohen, Steven R.

doi:10.1016/j.jaad.2013.01.009

Cited by 6 publications

(6 citation statements)

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“…Topical cantharidin is a commonly used treatment for verruca vulgaris and MC. [5][6][7] In a 2009 survey of pediatric dermatologists, approximately 99% of those polled had previously used topical cantharidin, with 92% reporting subjective satisfaction with its results. 7 However, validation of its safety and efficacy is limited.…”

Section: Discussionmentioning

confidence: 99%

“…We conducted a single-center, 6 Participants were stratified by age and gender to ensure adequate distribution. Blinded treatment was administered at weeks 0 and 3.…”

Section: Methodsmentioning

confidence: 99%

“…Some authors have reported intensifying the blistering by occlusion with nonporous tape to increase percutaneous absorption, typically for 4–6 hours . However, despite the prevalence of its use, cantharidin is not indicated by the Food and Drug Administration (FDA) for the treatment of MC, in part due to limited data supporting its use . In the following study, we performed a prospective, placebo‐controlled pilot trial to assess the safety and effectiveness of cantharidin in the treatment of pediatric MC.…”

Section: Introductionmentioning

confidence: 99%

“…4 Cantharidin, a topical vesicant derived from the blister beetle (Lytta vesicatoria), is a commonly used treatment for MC. [5][6][7] Its mechanism of action involves the activation or release of epidermal serine proteases that lead to tonofilament detachment, which in turn elicits intraepidermal blistering and inflammation that promotes shedding of infected keratinocytes and viral clearance. 8,9 Some authors have reported intensifying the blistering by occlusion with nonporous tape to increase percutaneous absorption, 9 typically for 4-6 hours.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of topical cantharidin for the treatment of pediatric molluscum contagiosum: a prospective, randomized, double‐blind, placebo‐controlled pilot trial

et al. 2018

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Topical cantharidin is a commonly used treatment for molluscum contagiosum (MC). However, studies validating its safety and efficacy are limited. We conducted a 6-week, randomized, double-blind, placebo-controlled trial with subsequent open-label extension to assess the safety and effectiveness of cantharidin in treating pediatric MC. Ninety-four participants with MC were randomized to receive cantharidin or placebo, with or without occlusion. The primary outcome was complete lesion clearance. Secondary outcomes included post-treatment lesion count, adverse events, and side effects. No significant differences between the study arms, including baseline lesion count, were observed. The overall mean (SD) baseline lesion count was 22.2 (12.9). The number of participants achieving total clearance is as follows: 7/23 (30.4%) in the cantharidin only arm, 10/24 (41.7%) in the cantharidin with occlusion arm, 2/25 (8.0%) in the placebo with occlusion arm, and 3/22 (13.6%) in the placebo only arm. Post hoc analysis demonstrated that 17/47 (36.2%) participants in the combined cantharidin arms achieved clearance compared to 5/47 (10.6%) in the placebo arms (P = 0.0065). The mean (SD) lesion count change from baseline was -5.1 (12.2) in the placebo only arm; the mean change (SD) was -17.4 (12.8) in the cantharidin only arm (P = 0.0033) and -15.9 (11.6) in the cantharidin with occlusion arm (P = 0.0101). No serious adverse events or side effects were observed. Topical cantharidin was well-tolerated and associated with the resolution of MC.

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Section: Discussionmentioning

confidence: 99%

“…We conducted a single-center, 6 Participants were stratified by age and gender to ensure adequate distribution. Blinded treatment was administered at weeks 0 and 3.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety and efficacy of topical cantharidin for the treatment of pediatric molluscum contagiosum: a prospective, randomized, double‐blind, placebo‐controlled pilot trial

et al. 2018

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“…Prášek z čínských puchýřníků druhu Mylabris phalerata nebo M. cichorii pod názvem "mylabris" byl a dodnes ještě je využíván v tradiční lidové medicíně řady asijských zemí, jako je Čína či Vietnam [7]. V současné době se o obsahové, biologicky účinné látky puchýřníků zajímá i moderní medicína [8,9]. Tato souhrnná práce přináší informace o kantaridinu, hlavní biologicky aktivní látce puchýřníků, o jeho historii, chemii, farmakologii a toxikologii a o možnostech jeho využití v současné biomedicíně.…”

Section: úVodunclassified

Cantharidin: natural bioactive molecule with a long history

Patočka¹,

Kuča²

2013

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sociální fakulta, katedra radiologie, toxikologie a ochrany obyvatelstva 2 Fakultní nemocnice v Hradci Králové, Centrum biomedicínského výzkumu 3 Univerzita obrany v Hradci Králové, Fakulta vojenského zdravotnictví, Centrum pokročilých studií summary Cantharidin, a vesicant produced by insects in the order Coleoptera, has a long history both in folk and traditional medicine. Cantharidin, terpenoid of 7-oxabicyclo-[2.2.1]-heptane type, is a poisonous chemical compound secreted by many species of blister beetle (Meloidae), and most notably by the Spanish fly, Lytta vesicatoria. In dermatology, diluted solutions of cantharidin can be used as a topical medication for the treatment of benign epithelial growths: to remove warts and to treat the small papules of Molluscum contagiosum. The potential of cantharidin for adverse effects has led to its inclusion in a list of hazardous drugs. The extreme risk in acute toxicity of cantharidin makes any use as an aphrodisiac. It is highly dangerous because it can easily cause death. As a result, it is illegal to use cantharidin for this purpose in many countries. Nevertheless, according to new clinical results, cantharidin is a safe and valuable medication and should be readded to the dermatologic therapeutic armamentarium. In addition to topical medical applications, cantharidin, as well as its some analogues (mainly norcantharidin), show potential anticancer activities. Laboratory studies with cultured tumor cell lines suggest that this activity may relate to inhibition of protein phosphatase 2A, a specific serine/threonine phosphatase that can dephosphorylate multiple kinases. It is generally considered to be a cancer suppressor and its inhibition can induce phosphorylation and activation of substrate kinases that mainly accelerate growth. Cantharidin has shown potent anticancer activities on human cancer cells. It induces cell cycle arrest and apoptosis in many types of cancer cells.

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Pooled Results of Two Randomized Phase III Trials Evaluating VP-102, a Drug-Device Combination Product Containing Cantharidin 0.7% (w/v) for the Treatment of Molluscum Contagiosum

Eichenfield

Siegfried

Kwong³

et al. 2021

Am J Clin Dermatol

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Background Compounded cantharidin has been used for decades to treat molluscum contagiosum but lacks rigorous clinical evidence to support its safety and efficacy. VP-102 is a shelf-stable drug–device combination product that contains topical cantharidin (0.7% weight/volume [w/v]) and is being evaluated for the treatment of molluscum. Objectives Our objective was to present pooled safety and efficacy analyses of VP-102 in the treatment of molluscum compared with vehicle. Methods Participants aged ≥ 2 years were randomized 3:2 to topical administration of VP-102 or vehicle in two randomized, double-blind, vehicle-controlled phase III trials. Study drug was applied to all baseline and new lesions once every 21 days until clear or for a maximum of four applications. Assessors blinded to treatment counted all lesions at each study visit. All adverse events (AEs) were documented. Data were pooled for analyses. Results In total, 310 participants received VP-102 and 218 received vehicle. Mean age was 7.5 years (range 2–60) for VP-102 and 6.8 (2–54) for vehicle. Complete clearance of all molluscum lesions at day 84 occurred in 50% of VP-102 participants and 15.6% of vehicle recipients ( p < 0.0001). Mean molluscum lesion counts decreased 76% for VP-102 and 0.3% for vehicle at day 84 ( p < 0.0001). The most common AEs in the VP-102 group were application site blistering, pruritus, pain, and erythema, which were generally mild or moderate in severity. Conclusions Pooled analyses showed a significantly higher percentage of participants with complete molluscum lesion clearance and larger reductions in lesion counts with VP-102 than with vehicle. AEs were anticipated because of the pharmacodynamic properties of cantharidin. Trial Registration ClinicalTrials.gov identifiers: NCT03377790 (first posted 19 December 2017) and NCT03377803 (first posted 19 December 2017). Supplementary Information The online version contains supplementary material available at 10.1007/s40257-020-00570-8.

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Cantharidin therapy: Practice patterns and attitudes of health care providers

Cited by 6 publications

References 4 publications

Safety and efficacy of topical cantharidin for the treatment of pediatric molluscum contagiosum: a prospective, randomized, double‐blind, placebo‐controlled pilot trial

Safety and efficacy of topical cantharidin for the treatment of pediatric molluscum contagiosum: a prospective, randomized, double‐blind, placebo‐controlled pilot trial

Cantharidin: natural bioactive molecule with a long history

Pooled Results of Two Randomized Phase III Trials Evaluating VP-102, a Drug-Device Combination Product Containing Cantharidin 0.7% (w/v) for the Treatment of Molluscum Contagiosum

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