inosine-pranobex and Warts

Proliferative verrucous leukoplakia (PVL) is a unique oral white lesion in which human papillomavirus (HPV) may play a role. PVL behaves far more aggressively than other forms of leukoplakia with a high rate of recurrence after surgical excision, and relentless progression to verrucous hyperplasia and to verrucous or squamous cell carcinomas. The treatment of PVL is usually by surgery, but there is often early recurrence. This study was an open trial of surgery in 25 patients with oral HPV-positive PVL, compared with combined therapy using surgery and methisoprinol in another group of 25 patients with oral PVL. Six months postoperatively there was a significant difference, with 18 recurrences in the patients treated by surgery alone compared to only two recurrences in the patients treated also with methisoprinol (isoprinosine or inosine pranobex), a synthetic agent with immunomodulatory properties and some antiviral activity against HPV. Eighteen months postoperatively there were no further recurrences in the patients treated by surgery alone but another two recurrences in the patients treated with methisoprinol. Overall, by 18 months follow-up, there were 18 recurrences in the group treated by surgery alone, compared with four in those also receiving methisoprinol. The use of this antiviral agent appeared to offer a significant enhancement to the surgical management of PVL.

Topics: Adult; Aged; Antiviral Agents; Chi-Square Distribution; Combined Modality Therapy; DNA Probes, HPV; Female; Humans; Inosine Pranobex; Leukoplakia, Oral; Male; Middle Aged; Mouth Neoplasms; Neoplasm Recurrence, Local; Papillomaviridae; Treatment Outcome; Warts

Four-hundred consecutive referrals with viral warts of the hands and/or feet were investigated to determine the cure rate from a combination of cryotherapy, keratolytic wart paint and paring. For treatment failures after 3 months, the value of continuing cryotherapy and of additional treatment with the immunomodulator inosine pranobex were assessed. Subjects were treated for 3 months with wart paint and cryotherapy and were randomized to receive, or not, paring in addition. Those who did not respond by 3 months were randomized to receive, or not, 3 months further cryotherapy, and to receive inosine pranobex 60 mg/kg/day for 1 week each month, or matching placebo. Fifty-two per cent of subjects were cured by 3 months. The chance of cure was inversely related both to the length of history and to the diameter of the largest wart. Paring improved the cure rate for plantar warts but not for hand warts. During the second 3 months the cure rate fell to 41%. Neither cryotherapy nor inosine pranobex significantly improved this response.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Combined Modality Therapy; Cryosurgery; Drug Therapy, Combination; Female; Foot Dermatoses; Hand Dermatoses; Humans; Inosine Pranobex; Male; Middle Aged; Random Allocation; Time Factors; Treatment Outcome; Warts

One hundred and sixty five heterosexual men and women with genital warts were treated with inosine pranobex (Imunovir) or conventional treatment, or both. Inosine pranobex was found to be more effective in lesions of longer duration, whereas conventional treatment was more effective in genital warts of a shorter duration. Supplementation of conventional treatment with inosine pranobex increased the success rate from 41% to 94%. Immunological studies in 134 patients with genital warts showed an increased number of B cells in 21% of peripheral blood samples. Absence of major defects among circulating lymphocytes suggested that patients with genital warts may have a local immune reaction.

Topics: Adjuvants, Immunologic; Adult; Clinical Trials as Topic; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Inosine; Inosine Pranobex; Male; Podophyllin; Prospective Studies; Random Allocation; Warts