inosine-pranobex and Condylomata-Acuminata

Conventional therapies for human papillomavirus infection aim to remove clinically apparent lesions, while latent infection may remain, representing a threat for transmission and carcinogenesis. The use of a systemic agent may more effectively control the virus. We conducted a randomised placebo-controlled study to investigate the efficacy and safety of oral inociplex in the treatment of cervical condylomata acuminata (CA) that had been resistant to conventional therapies. Thirty-eight white European women, aged 20-43 years, with genital warts of the cervix, refractory to at least one conventional therapy, were randomly assigned to receive either inosiplex, 50 mg/kg daily peros for 12 weeks (group 1), or placebo (group 2). Of the 17 evaluable group 1 women, 4 responded to the treatment completely, 7 responded partially and 6 did not respond. Of the 19 group 2 women, none responded to the treatment completely, 3 responded partially and 16 did not respond. The therapeutic difference between women receiving active and placebo therapy was statistically significant (chi(2)= 6.69, P < 0.01) and remained significant when an intention-to-treat analysis was performed (chi(2)= 7.69, P < 0.01). None of the complete responders experienced recurrence during the 12-month follow up. Adverse effects were mild and resolved upon completion of therapy. Compared with placebo, inosiplex showed considerable efficacy with insignificant and reversible adverse effects and without recurrences. Inosiplex may represent an efficacious and safe alternative systemic form of therapy for cervical genital warts.

Topics: Administration, Oral; Adult; Antiviral Agents; Condylomata Acuminata; Drug Resistance, Viral; Female; Humans; Inosine Pranobex; Secondary Prevention; Treatment Outcome; Uterine Cervical Diseases

In a multicentre, prospective, randomised, placebo controlled study of 55 patients with histories of genital warts for at least one year, a four week course of inosine pranobex 3 g a day improved the clinical response to conventional treatment (primarily podophyllin or trichloroacetic (now called trichlorethanoic) acid). Although more patients given inosine pranobex improved than those given placebo, the difference in general response between the two groups was not significant. When other variables (numbers of warts and extent of lesions) were considered, however, the patients given inosine pranobex fared significantly better. These results suggest that inosine pranobex may be worth considering as adjunct to treatment of patients with refractory genital warts.

Topics: Adult; Clinical Trials as Topic; Condylomata Acuminata; Double-Blind Method; Female; Humans; Immunotherapy; Inosine; Inosine Pranobex; Male; Multicenter Studies as Topic; Placebos; Podophyllin; Prospective Studies; Trichloroacetic Acid

Topics: Administration, Oral; Antiviral Agents; Condylomata Acuminata; Female; Humans; Inosine Pranobex; Randomized Controlled Trials as Topic; Uterine Cervical Diseases

Medical therapy of genital condylomatosis seems to be the most rational strategy, since this pathology is characterised by highly frequent recurrences after destructive physical therapy alone. Successful therapy of female genital condylomatosis with methisoprinol (Viruxan), administered as ointment and/or vaginal ovules is reported. The drug proved to be efficient both in curing this viral infection and preventing its recurrences.

Topics: Administration, Topical; Adolescent; Adult; Condylomata Acuminata; Female; Genital Neoplasms, Female; Humans; Inosine; Inosine Pranobex; Middle Aged

Several modes of therapy are presently available for treatment of genital warts. These include use of keratolytics such as podophyllin or trichloroacetic acid, electrocoagulation, cryotherapy, and laser therapy. Responses have not been uniformly successful, however, and particularly in patients with resistant warts there is evidence of impairment of cell-mediated immunity (CMI). In the healing process both humoral and CMI responses are of importance, and indeed it has been reported that in patients with recalcitrant viral warts the lesions disappeared at the same time the CMI response returned to normal. Isoprinosine is an orally administered drug known to have both in vitro and in vivo immunopotentiating activity and has been shown previously to restore toward normal the depressed CMI responses of diverse etiology accompanying a variety of clinical conditions. Recent evidence implicating certain types of genital warts in later development of cervical cancer in females has led to the search for a more effective treatment of this condition. Clinical studies to date involving the use of isoprinosine alone or in combination appear to have established the role of this safe and easily administered oral drug in increasing the chances of total eradication of condylomatous lesions and sparing a high percentage of patients from having to undergo repeated and more traumatic therapies.

Topics: Condylomata Acuminata; Female; Humans; Immunity, Cellular; Inosine; Inosine Pranobex

Topics: Colposcopy; Condylomata Acuminata; Female; Humans; Inosine; Inosine Pranobex; Papillomaviridae; Polyomaviridae; Tumor Virus Infections; Uterine Neoplasms

Condylomata are of viral origin and are found in increasing frequency. The CO2 laser has contributed significantly to the treatment of this condition with a failure rate approximating 35 p. cent of cases. Two groups of patients with cervical or vulvovaginal condylomata were treated by CO2 laser or by CO2 laser and Isoprinosine. After the initial treatment, there were 31,6 p. cent failures in the group treated only by CO2 laser in patients with cervical condylomata, and 66,3 p. cent failures in those with vulvovaginal condylomata. Following 3 laser treatments, there was a 5,3 p. cent failure rate with the cervical condylomata, and 33,3 p. cent with the vulvovaginal condylomata. In the group treated by CO2 laser and Isoprinosine, there were 6,9 p. cent failures in patients with cervical condylomata and 5,7 p. cent failures in those with vulvovaginal condylomata following the initial treatment. After 3 treatments there were no failures. The combined use of CO2 laser and Isoprinosine reduces significantly the number of recurring condyloma acuminata, and appears to us to be an effective form of treatment.

Topics: Adjuvants, Immunologic; Condylomata Acuminata; Female; Humans; Inosine; Inosine Pranobex; Laser Therapy