Podophyllotoxin versus Pulsed Dye Laser in the Treatment of HPV-related genital warts

Abstract

Background Anogenital warts are one of the most common sexually transmitted diseases, caused by the human papillomavirus (HPV). The therapy with topical 0.5 % podophyllotoxin solution (Condylox®) is one of the most effective treatment options, and is applied by the patient ov-er several weeks. The pulsed dye laser (PDL) represents a new treatment alternative, which eradicates the warts in a fast and potent manner. This study compares both treatment options, laser and podophyllotoxin, in terms of efficacy (reduced number of warts and infected area) as rated by the physician, and also regarding side effects (perceived pain) and quality of life. (How satisfied was the patient with the treatment) rated by the patient. The study was designed as an equivalence trial. Methods From the year 2012 to 2014, 48 patients (46 male, 2 female) with anogenital warts took part in a randomized and controlled, observer -blinded, monocentric trial at the outpatient venereology department in Graz. The patients were randomly assigned to either therapy with self-applied podophyllotoxin over a duration of several weeks or a PDL treatment, carried out by a trained physician. A 595 nm PDL Candela Vbeam Perfecta was used with the following specifications: energy density 12 J/cm², length of impulse 1.5 milliseconds, spot size 7 mm. Two laser impulses per wart were applied. The first treatment took place on day one, with a second treatment (if necessary) three weeks later. At a follow-up appointment about six weeks later, the efficacy of the therapy was evaluated by a physician, and the patients were asked to fill out a questionnaire regarding the experienced side effects (pain), and how comfortable the procedure was perceived (quality of life).   Results After a strict selection through the inclusion/exclusion criteria, 36 male patients were selected for the statistical analysis. Statistics did not find any significant difference in efficacy (measured by the reduced number of warts and reduced infected area in mm²), the significance level being 0.403 and 0.855 with α-level of

Date of Award	2017
Original language	English
Awarding Institution	Medical University Graz
Supervisor	Peter Komericki (Supervisor)