5-Fluorouracil for genital warts
Evidence Summaries
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).