Genital Warts Treatment: Immunomodulatory Therapy
Imiquimod
Imiquimod 0.5% cream Approved by Health Canada in 1999.
How does it work
Enhances the cell killing immune response, which is usually seen as an inflammatory response. It acts to reduce the viral load, thereby reducing recurrence rates to very low levels. Works better on the moist mucosal surfaces compared with regular skin.This may explain why it may be more effective for treating genital warts in women.
Applied directly to the affected skin 3 times per week for up to 16 weeks. Initially the frequency of applications can be reduced if the patient is over concerned by the degree of inflammation.
- Advantages - Topical cream - administered by patient. Self-administration improves patient compliance. Its ability to affect subclinical lesions which are sites where the effects of the HPV is not obvious on the skin. Studies have shown that over 50% of patients clear their warts at 16 weeks. The recurrence rate is up to 19% which is lower that alternative treatment options.
- Disadvantages - Needs up to 16 weeks of therapy. Causes inflammation which reflects the fact that the immune system is being activated to attack the HPV. Safety in pregnancy has not been established.
Genital Warts Treatment:
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