Topical Imiquimod 5% Cream as an Effective Treatment for External Genital and Perianal Warts in Different Patient Populations

In Brief Background Genital infection with human papillomavirus, the cause of genital warts, is one of the most common sexually transmitted diseases. Goal The aim of this analysis was to determine whether patients’ demographic variables affect the efficacy of imiquimod 5% cream versus vehicle cream for the treatment of external genital and perianal warts. Study Design Male and female immunocompetent patients applied imiquimod 5% cream topically to external genital warts 3 times a week until wart clearance or for up to 16 weeks. Results As previously published, the intent-to-treat (ITT) clearance rate was 50% (54/109) in the imiquimod-treated group and 11% (11/100) in the vehicle-treated group (P < 0.0001). The ITT clearance rate in the imiquimod-treated group was higher in females (72%) than in males (33%). We have examined the clearance rates for subgroups based on variables of gender, baseline wart area, duration of current outbreak of warts, previous wart treatment, and tobacco use. For each of these subgroups, imiquimod was statistically more effective than vehicle in eradicating external genital and perianal warts. Conclusion Imiquimod 5% cream is an effective treatment for external genital and perianal warts and provides a significant benefit in comparison with vehicle cream, independent of gender, initial wart size, duration of current outbreak of warts, previous wart treatment, or tobacco use. In a double-blind randomized clinic trial, imiquimod 5% cream was an effective treatment for external genital and perianal warts, providing more significant benefit than vehicle cream, independent of gender, initial wart size, duration of current wart outbreak, previous therapy, or smoking habits.