Adverse Effects of Treatments for Anogenital Warts in Non-immunocompromised Adults: A Network Meta-analysis of Randomized Controlled Trials.

IF 4.6 3区 医学 Q1 DERMATOLOGY
Dermatology and Therapy Pub Date : 2026-09-01 Epub Date: 2026-07-27 DOI:10.1007/s13555-026-01857-0
Réda Saib, Elisa Joly, Sébastien Fouere, Christian Derancourt, Babacar Tounkara, Cyril Ferdynus, Antoine Bertolotti
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Abstract

Introduction: International guidelines for the management of anogenital warts (AGWs) propose multiple first-line options but do not prioritize treatments based on safety or tolerability. This study aimed to compare the safety profiles of topical, systemic, and ablative treatments used for external AGWs in immunocompetent adults.

Methods: A systematic review and frequentist network meta-analysis of randomized controlled trials published through August 2025 was performed. Adverse events (AEs) were classified as low-, moderate-, or high-grade local AEs (LGL, MGL, HGL) and low-grade general AEs (LGG). Relative risks were estimated using random-effects models with placebo as the reference.

Results: We included 107 RCTs involving 12,423 participants. Ablative procedures were associated with higher rates of moderate-to-severe local AEs compared with topical therapies. Among topical treatments, imiquimod 5% and cidofovir cream were associated with lower rates of severe AEs, whereas podophyllotoxin was more often associated with LGL. SUCRA rankings placed topical treatments above ablative therapies in terms of tolerability. Cidofovir cream demonstrated the best safety profile, followed by imiquimod 5%.

Conclusion: This network meta-analysis highlights significant differences in tolerability across AGW treatments and offers a comparative framework for patient-centered therapeutic decision-making. It also emphasizes the need for standardized AE reporting in future trials.

非免疫功能低下成人肛门生殖器疣治疗的不良反应:随机对照试验的网络meta分析。
导论:肛门生殖器疣(agw)管理的国际指南提出了多种一线选择,但没有根据安全性或耐受性优先考虑治疗。本研究旨在比较免疫功能正常成人外用AGWs的局部、全身和消融治疗的安全性。方法:对截至2025年8月发表的随机对照试验进行系统评价和频率网络荟萃分析。不良事件(ae)分为低、中、高级别局部ae (LGL、MGL、HGL)和低级别一般ae (LGG)。使用随机效应模型估计相对风险,安慰剂作为参考。结果:我们纳入107项随机对照试验,涉及12423名受试者。与局部治疗相比,消融手术与较高的中度至重度局部不良事件发生率相关。在局部治疗中,5%咪喹莫特和西多福韦乳膏与较低的严重不良反应发生率相关,而鬼臼毒素更常与LGL相关。就耐受性而言,SUCRA排名将局部治疗置于消融治疗之上。西多福韦乳膏的安全性最好,其次是5%的咪喹莫特。结论:该网络荟萃分析强调了AGW治疗之间耐受性的显着差异,并为以患者为中心的治疗决策提供了比较框架。它还强调了在未来试验中标准化AE报告的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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