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#2
21.05.2003, 10:08
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Попробуйте Aldara® (Imiquimod) 5% kpem: дорого, но доказано, что излечивает.
Источник знаний:J Dermatol 1998 Jul;25(7):429-33 Management of female genital warts with an analog of imiquimod 2% in cream: a randomized, double-blind, placebo-controlled study. Syed TA, Ahmadpour OA, Ahmad SA, Ahmad SH. Department of Dermatology University of California San Francisco 94143-0989, USA. The purpose of this randomized, double-blind, placebo-controlled study was to determine the clinical efficacy and tolerability of an analog of imiquimod (2%)in cream to cure genital warts in women. Sixty preselected women, ranging between 18 and 45 years of age (mean 24.3) and having 411 lesions (mean 6.8) with clinical, histopathological and polymerase chain reaction (PCR) confirmed diagnosis of human papilloma virus (HPV) infection were randomized to two parallel groups. Each patient received a precoded 40-g tube and instructions on how to apply the trial medication to their lesions at home two times daily for five consecutive days per week. The active treatment period was six weeks. Patients were evaluated on a weekly basis. A clinically and PCR established total clearance of target warts was recorded as a cure. By the end of the treatment, 43.3% of patients and 42.8% of warts were cured. Code disclosure revealed that imiquimod cream had cured 83.3% of the treated patients and 84.3% of the tested warts, while the placebo healed one subject and four warts (p < 0.0001). Eight patients (13.3%) in the imiquimod group experienced mild to moderate, non-objective, drug-induced symptoms with no dropouts. Among the 26 cured patients, five had a relapse after 11 months. In conclusion, the data presented demonstrate that 2% imiquimod in cream with mild to moderate subjective side effects is significantly more effective than placebo in eliminating genital warts in women. 
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#3
21.05.2003, 11:38
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Интересно, а что это были за mild to moderate, non-objective, drug-induced symptoms with no dropouts и после 1998 г были ли дальше исследования?
В аптеках так и будет называться, Алдара? Какой-нибудь FDA ее одобрил? И если есть не только genital, но и anal, тоже можно попробовать? Еще вопрос - ВПЧ 16,18 методом ПЦР в мазке не обнаружен. нужно сдавать кровь на ПЦР по ВПЧ?
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#4
21.05.2003, 15:07
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А Вы, уважаемая, смотрю весьма подкованы в выборе лекарств (интересно мазь туи проходила ли клин. испытания и одобрена ли еще кем, кроме отечественных гомеопатов?). О дальнейших клин. испытаниях (плюс анальная область) и одобрениях здесь (похоже, что подтверждение наличия ВПЧ не проводилось):
PARIS, FRANCE -- July 5, 2002 -- Imiquimod 5 percent cream is a safe and effective treatment for external genital and perianal warts, researchers reported at the 20th World Congress of Dermatology (WCD). Dr. Selim Aractingi, with Tenon Hospital in Paris, France, presented the results of an open-label study that evaluated the safety and efficacy of imiquimod 5 percent cream in 943 patients with external genital/perianal warts. Patients applied the cream three times per week for up to 16 weeks. If the warts cleared, the patients entered a six-month follow-up; patients whose warts partially cleared in the initial treatment period or who experienced recurrence during follow-up were treated for up to 16 additional weeks. A total of 66 percent of patients experienced total clearance during the initial and extended treatment periods. The overall clearance rate in an intent-to-treat analysis was 53 percent. The median time to clearance was 8.8 weeks. Among patients who experienced total clearance during treatment 23 percent experienced recurrent or new wart growth during six months of follow-up. In the patients who reapplied imiquimod following wart recurrence, imiquimod was effective in reclearing warts in 70 percent of patients. The most common local skin reaction observed by investigators was erythema, which was experienced by 67 percent of patients. Most local skin reactions were mild to moderate in severity. For patients who continued treatment beyond 16 weeks or reapplied imiquimod following wart recurrence, the frequency of local skin reactions decreased from the first treatment period to the subsequent one. Results also showed that patients rated imiquimod as better than other genital wart therapies they had previously received in terms of overall satisfaction, convenience, lack of associated pain, and length of time to wart clearance. More than 85 percent of physicians asked to rate therapies for genital warts cited imiquimod as a convenient treatment option. Furthermore, physicians believed that their patients experienced little or no pain with imiquimod treatment. Imiquimod, an immune response modifier, is recommended as a patient-applied treatment option for external genital and perianal warts by guidelines from the Centers for Disease Control and Prevention and government health bodies in Europe and Latin America. The study was sponsored by 3M Pharmaceuticals. Int J STD AIDS 2003 Jan;14(1):11-7 Effectiveness, satisfaction and compliance with imiquimod in the treatment of external anogenital warts. Vilata JJ, Badia X; ESCCRIM group. Departamento de Dermatologia, Hospital General Universitario, Valencia, Spain. This study aims to evaluate the effectiveness of imiquimod treatment of external anogenital warts and analyse its possible relationship with patient treatment satisfaction and compliance under conditions of routine clinical practice. An observational, prospective and multi-centre study was conducted in a cohort of 559 patients with external anogenital warts. Imiquimod 5% cream was administered three times a week until the end of treatment (complete wart clearance or up to a maximum of 16 weeks). Effectiveness and compliance were evaluated at four weeks and again at the end of treatment, when satisfaction was also assessed. Complete wart clearance was experienced by 66.6% of patients at the end of treatment and a 50% or greater reduction in total wart area occurred in 79.5%. Imiquimod was more effective in patients who were more satisfied and compliant with treatment. Under conditions of routine clinical practice, imiquimod is an effective treatment for external anogenital warts. Int J STD AIDS 2001 Nov;12(11):722-9 Imiquimod 5% cream is a safe and effective self-applied treatment for anogenital warts--results of an open-label, multicentre Phase IIIB trial. Garland SM, Sellors JW, Wikstrom A, Petersen CS, Aranda C, Aractingi S, Maw RD; Imiquimod Study Group. Department of Microbiology and Infectious Diseases, Royal Women's and Royal Children's Hospitals, Melbourne, Australia. Our objective was to determine the efficacy and safety of imiquimod 5% cream in the treatment of external genital/perianal warts in an open-label Phase IIIB trial. Patients applied imiquimod 5% cream 3 times per week, for up to 16 weeks. Those who cleared their warts were monitored during a 6-month follow-up period. If their warts recurred, or new warts developed during this time, patients could be re-treated for up to 16 additional weeks. Patients who experienced partial clearance during the initial treatment period entered an extended treatment period of up to an additional 16 weeks. A total of 943 patients from 114 clinic sites in 20 countries participated in this study. Complete clinical clearance was observed in 451/943 (47.8%) patients (intent-to-treat (ITT) analysis) during the initial treatment period, with clearance in an additional 52 (5.5%) patients during the extended treatment period beyond 16 weeks. The overall clearance rate for the combined treatment periods was 53.3%. In a treatment failure analysis, the overall clearance rate was 65.5%; a greater proportion of female patients (75.5%) experienced complete clearance than male patients (56.9%). Low recurrence rates, of 8.8% and 23.0%, were observed at the end of the 3- and 6-month follow-up periods, respectively. The sustained clearance rates (patients who cleared during treatment and remained clear at the end of the follow-up period) after 3 and 6 months were 41.6% and 33.0% (ITT analysis), respectively. Local erythema occurred in 67% of patients. In the majority of patients local skin reactions were of mild to moderate severity. In conclusion, imiquimod 5% cream is an effective self-applied treatment for external genital/perianal warts when applied for up to 16 weeks and is well tolerated for up to 32 weeks.
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#5
21.05.2003, 15:19
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В аптеке он так и должен называться (если есть конечно). Производитель/лицензент должна быть компания 3М Pharm.
по последнему вопросу затрудняюсь ответить, может это проявления др. кожных заболеваний (напр. контагиозный моллюск?), тоже лечится Альдарой: Br J Dermatol 2000 Nov;143(5):1026-31 Self-administered topical 5% imiquimod for the treatment of common warts and molluscum contagiosum. Hengge UR, Esser S, Schultewolter T, Behrendt C, Meyer T, Stockfleth E, Goos M. Department of Dermatology, Venereology and Allergology, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany. J Cutan Med Surg 2000 Apr;4(2):76-82 Imiquimod therapy for molluscum contagiosum. Liota E, Smith KJ, Buckley R, Menon P, Skelton H. Department of Dermatology, National Naval Medical Center, Bethesda, Maryland 20089-5600, USA Dermatol Online J 2001 Feb;7(1):20 An open label safety study of topical imiquimod 5% cream in the treatment of Molluscum contagiosum in children. Barba AR, Kapoor S, Berman B. Univeristy of Miami Department of Dermatology and Cutaneous Surgery, USA. О других областях его применения: Skin Therapy Lett 2002 Nov;7(9):1-6 Novel dermatologic uses of the immune response modifier imiquimod 5% cream. Berman B, Poochareon VN, Villa AM. Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL, USA. Imiquimod is the first of a new class of drugs to emerge in the treatment of various dermatologic disorders. As an immune response modifier, it has been shown to have potent antiviral and antitumor properties through the stimulation of innate and cell mediated immune pathways. It is currently approved for the treatment of external genital and perianal warts, but has also been found to be an effective treatment for a host of other virus-associated dermatologic lesions, including common and flat warts, molluscum contagiosum and herpes simples 2. Oncological lesions showing improvement with the use of imiquimod include basal cell carcinoma, actinic keratosis, squamous cell carcinoma in situ, malignant melanoma, cutaneous T-cell lymphoma, and cutaneous extramammary Paget's disease. Recent case studies have also found this product to be effective for treating keloids, infantile hemangiomas, porokeratosis of Mibelli, leishmanisis, and tattoo removal. This extensive array of disorders treated successfully with imiquimod warrants further study of this novel and valuable drug.
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Линейный вид
