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Imiquimod Is Effective in Reducing Cervical Intraepithelial Neoplasia: A Systematic Review and Meta-Analysis.
Hamar, Balázs; Teutsch, Brigitta; Hoffmann, Eszter; Hegyi, Péter; Harnos, Andrea; Nyirády, Péter; Hunka, Zsombor; Ács, Nándor; Bánhidy, Ferenc; Melczer, Zsolt.
Afiliação
  • Hamar B; Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary.
  • Teutsch B; Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary.
  • Hoffmann E; Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary.
  • Hegyi P; Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary.
  • Harnos A; Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary.
  • Nyirády P; Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary.
  • Hunka Z; Centre for Translational Medicine, Semmelweis University, 1088 Budapest, Hungary.
  • Ács N; Institute for Translational Medicine, Medical School, University of Pécs, 7621 Pécs, Hungary.
  • Bánhidy F; Institute of Pancreatic Diseases, Semmelweis University, 1088 Budapest, Hungary.
  • Melczer Z; Department of Biostatistics, University of Veterinary Medicine, 1078 Budapest, Hungary.
Cancers (Basel) ; 16(8)2024 Apr 22.
Article em En | MEDLINE | ID: mdl-38672691
ABSTRACT

INTRODUCTION:

Topical Imiquimod is an immune response modifier approved for the off-label use of vulvar intraepithelial neoplasia. We conducted this systematic review and meta-analysis to investigate the efficacy and safety of Imiquimod in treating cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV)-positive patients.

METHODS:

The study was prospectively registered (CRD420222870) and involved a comprehensive systematic search of five medical databases on 10 October 2022. We included articles that assessed the use of Imiquimod in cervical dysplasia and HPV-positive patients. Pooled proportions, risk ratios (RRs), and corresponding 95% confidence intervals (CIs) were calculated using a random effects model to generate summary estimates. Statistical heterogeneity was assessed using I2 tested by the Cochran Q tests.

RESULTS:

Eight articles reported on 398 patients who received Imiquimod out of 672 patients. Among CIN-2-3 patients, we observed a pooled regression rate of 61% (CI 0.46-0.75; I2 77%). When compared, Imiquimod was inferior to conization (RR 0.62; CI 0.42-0.92; I2 64%). The HPV clearance rate in women who completed Imiquimod treatment was 60% (CI 0.31-0.81; I2 57%). The majority of side effects reported were mild to moderate in severity.

CONCLUSIONS:

Our findings indicate that topical Imiquimod is safe and effective in reducing cervical intraepithelial neoplasia and promoting HPV clearance. However, it was found to be inferior compared to conization. Imiquimod could be considered a potential medication for high-grade CIN patients and should be incorporated into guidelines for treating cervical dysplasia.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article