Ingenol mebutate for the treatment of anogenital condylomata acuminata

Magdaleno‐Tapial, Jorge; Valenzuela‐Oñate, Cristian; Weth, Macarena Giacaman-von der; Ferrer-Guillén, Blanca; Martínez, Marta García-Legaz; Martínez‐Doménech, Álvaro; Hernández-Bel, P.

doi:10.1111/ced.13840

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…The recurrence rate was reported by 18% up to 12 months of follow-ups. 5 Despite the high incidence of complete resolution and low reported recurrence rates in the previous studies, in our series, initially, AGWs were completely cleared in 10 (66%) patients while 4 (40%) patients experienced the recurrence within a 3-month followup meaning that the 3-month complete clearance of AGWs was achieved in only six (40%) cases. It should be noted that the patient population was mainly consisted of the refractory cases in this trial possibly explaining the observed lower clearance rate and a high recurrence rate in this study.…”

Section: Discussioncontrasting

confidence: 71%

“…In another study, 11 of 15 (73.3%) patients with AGWs showed the complete clearance after application of the IM gel (0.15% or 0.05%). The recurrence rate was reported by 18% up to 12 months of follow‐ups 5 …”

Section: Discussionmentioning

confidence: 98%

“…Some published case reports and case series have shown the therapeutic benefits of IM gels 0.15% and 0.05% for treatment of the AGWs (Table 2). [5][6][7][8][9][10][11][12][13] IM gel 0.05% has been used successfully to treat the genital warts in the sensitive anatomic locations. 6 Several studies have reported the patients with genital warts at the corona of glans penis or meatus, and peri and intra-anal skin who were completely treated following application of the IM gel 0.05% for 1 to 2 weeks with no recurrence during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…2 Some reports have demonstrated that the IM gel 0.05% gel is safe and effective in the treatment of external AGWs. 4,5 But the efficacy of the drug on the recalcitrant AGWs is not clear.…”

Section: Introductionmentioning

confidence: 99%

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Ingenol mebutate for the management of cryotherapy‐resistant anogenital warts

Dadras

Hoormand

Bizaval

et al. 2020

Dermatologic Therapy

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Ingenol mebutate (IM), as an active compound, is derived from the sap of the Euphorbia peplus, which is an FDA-approved plant for the treatment of actinic keratosis. Some reports have demonstrated that the IM gel 0.05% is safe and effective in the treatment of external anogenital warts (AGWs) but the efficacy of the drug on the recalcitrant AGWs is not clear. This article assesses the efficacy and safety of the IM gel 0.05% for cryotherapy-resistant AGWs. Totally, 15 cryotherapy-resistant patients with AGWs (including 8 men and 7 women) and a mean age of 34 years old (age range of 23-50 years old) were enrolled in this study. IM gel 0.05% was applied carefully on the AGWs every two weeks for a maximum of three cycles. The complete clearance rate and recurrence rate were assessed

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

“…2 Some reports have demonstrated that the IM gel 0.05% gel is safe and effective in the treatment of external AGWs. 4,5 But the efficacy of the drug on the recalcitrant AGWs is not clear.…”

Section: Introductionmentioning

confidence: 99%

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Ingenol mebutate for the management of cryotherapy‐resistant anogenital warts

Dadras

Hoormand

Bizaval

et al. 2020

Dermatologic Therapy

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“…AGW are benign epithelial tumors caused by an infection with certain types of human papillomavirus (HPV) [ 4 ]. Many individual case reports, smaller case series, and initial pilot studies have shown, that IM gel application effectively and quickly removes AGW [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. In most cases, a single application of the gel was sufficient to ablate the warts within 24 h. After 8 h, the treated warts showed clinical signs of necrosis and peeled off within the next 24 h. Some patients felt severe pain at the treatment site, which peaked after 8 h and quickly ameliorated over the next half day.…”

Section: Introductionmentioning

confidence: 99%

Immunothrombotic Mechanisms Induced by Ingenol Mebutate Lead to Rapid Necrosis and Clearance of Anogenital Warts

Braun

Bauer

Németh

et al. 2022

IJMS

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Ingenol mebutate (IM) is highly effective in the treatment of human papillomavirus (HPV)-induced anogenital warts (AGW) leading to fast ablation within hours. However, the exact mode of action is still largely unknown. We performed dermoscopy, in vivo confocal microscopy (CLM), histology, immunohistochemistry, and immunofluorescence to gain insights in mechanisms of IM treatment in AGW. In addition, we used in vitro assays (ELISA, HPV-transfection models) to further investigate in vivo findings. IM treatment leads to a strong recruitment of neutrophils with thrombosis of small skin vessels within 8 h, in a sense of immunothrombosis. In vivo and in vitro analyses showed that IM supports a prothrombotic environment by endothelial cell activation and von Willebrand factor (VWF) secretion, in addition to induction of neutrophil extracellular traps (NETosis). IM superinduces CXCL8/IL-8 expression in HPV-E6/E7 transfected HaCaT cells when compared to non-infected keratinocytes. Rapid ablation of warts after IM treatment can be well explained by the observed immunothrombosis. This new mechanism has so far only been observed in HPV-induced lesions and is completely different from the mechanisms we see in the treatment of transformed keratinocytes in actinic keratosis. Our initial findings indicate an HPV-specific effect, which could be also of interest for the treatment of other HPV-induced lesions. Larger studies are now needed to further investigate the potential of IM in different HPV tumors.

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Ingenol Mebutate Gel 0.05% in the Treatment of Anogenital Warts: A Prospective Controlled Trial Comparing It With Topical Podophyllin Solution 25%

et al. 2020

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Background Anogenital warts (AGWs) are a common therapeutic challenge. All therapies are associated with burning, pain, and frustrating high rate of recurrence. The search for a new alternative continues. Recently, a diterpene ester extracted from the Euphorbia peplus plant (ingenol mebutate [IM]) has been shown to possess activity against AGWs. Objective This study aimed to compare and evaluate the therapeutic efficacy and safety of topical 0.05% ingenol gel with another herbal extract medication (topical 25% podophyllin solution) in treatment of AGWs. Methods This was a comparative single blinded nonrandomized, 2-arm trial of ingenol 0.05% gel versus podophyllin solution 25% administered up to 6 times to patients with AGWs. To evaluate the therapeutic efficacy, the complete clearance rate and recurrence rate were assessed 1 and 12 weeks after last treatment, respectively. Safety was assessed by occurrence and severity of pain and local skin reaction (LSR). Results Of 31 and 36 patients in the IM group and podophyllin group who completed the study, initial complete resolution was observed in 20 (64.5%) and 14 (38.9%) patients, respectively (P = 0.03). The initial clearance was faster in the IM group (2.00 ± 0.91 weeks) compared with the podophyllin group (4.21 ± 1.05 weeks, P = 0.00). After 3 months, recurrence was seen in 13 (65.0%) of 20 patients in the IM group and 6 (42.8%) of 14 in the podophyllin group (P = 0.20). The number of patients with complete resolution after 3 months was not different between the 2 groups (7/31 in the IM group and 8/36 in the podophyllin group, P = 0.97). The mean ± SD severity scores for LSR and pain in the IM group were 6.65 ± 1.76 and 6.13 ± 2.57, respectively, which was significantly higher than their scores (3.39 ± 1.57 and 2.58 ± 1.38) in the podophyllin group (P = 0.00). Conclusion Ingenol mebutate 0.05% gel is effective as podophyllin 25% solution in treating AGWs, with further benefit of being much more rapid. However, high recurrence rate, sever pain, and LSR limit its use.

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Ingenol mebutate for the treatment of anogenital condylomata acuminata

Abstract: Click https://www.wileyhealthlearning.com/ced.aspx for the corresponding questions to this CME article.

Cited by 4 publications

References 6 publications

Ingenol mebutate for the management of cryotherapy‐resistant anogenital warts

Ingenol mebutate for the management of cryotherapy‐resistant anogenital warts

Immunothrombotic Mechanisms Induced by Ingenol Mebutate Lead to Rapid Necrosis and Clearance of Anogenital Warts

Ingenol Mebutate Gel 0.05% in the Treatment of Anogenital Warts: A Prospective Controlled Trial Comparing It With Topical Podophyllin Solution 25%

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