5-Fluorouracil for genital warts

Evidence Summaries

Level of Evidence = D
5-Fluorouracil might possibly be effective for genital warts compared with placebo or podophyllin in non-immunocompromised individuals.

A Cochrane review 1 included 6 studies with a total of 988 subjects (645 women and 343 men). 5-Fluorouracil (5–FU) presented better results for cure than placebo or no treatment (RR 0.39, 95% CI 0.23 to 0.67; 3 trials, n=209), meta-cresol-sulfonic acid (MCSA) (RR 2.11, 95% CI 0.83 to 5.37; 1 trial, n=83), and podophyllin 2%, 4% or 25% (RR 1.26, 95% CI 0.86 to 1.82, 2 trials, n=156). There were no statistical differences for treatment failure for 5-FU vs CO2 Laser (RR 0.69, 95% CI 0.43 to 1.11; 1 trial, n=49),or 5-FU vs 5-FU + INFα-2a (low dose) (RR 1.02, 95% CI 0.87 to 1.119). The concentration of 5-FU varied in different studies.

Comment: The quality of evidence is downgraded by several shortcomings in study quality, by inconsistency (heterogeneity in interventions and outcomes), and by imprecise results (limited study size for each comparison).

References

1. Batista CS, Atallah AN, Saconato H, da Silva EM. 5-FU for genital warts in non-immunocompromised individuals. Cochrane Database Syst Rev 2010 Apr 14;4:CD006562.  [PMID:20393949]

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