Efficacy and Tolerability of Treatment With Tazarotene vs Imiquimod in Patients With Plane Warts
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Plane warts when multiple and recurrent present a therapeutic challenge acting as a source of reinfection causing frustration and affecting patient's quality of life. For lesions of large numbers in cosmetically significant sites, topical treatment is preferred to avoid potential sequelae.
OBJECTIVES
To evaluate and compare the efficacy and tolerability of tazarotene 0.1% gel versus imiquimod 5% cream for the treatment of plane warts.
METHODS
In a parallel three-arm randomized controlled trial, 60 patients were randomized into imiquimod, tazarotene or placebo groups. Patients applied the corresponding treatment once daily at night for a maximum of 12 weeks. Primary outcomes were percentage of respondents with complete clearance in the three studied groups, the type and frequency of side effects in each group.
RESULTS
Both active treatments resulted in significant improvement compared to baseline and to placebo group (P=0.001). Imiquimod 5% treated group showed complete clearance in 50% of cases, partial response in 15%, and no response in 35%. Tazarotene 0.1% gel showed complete clearance in 40% of cases, partial response in 40%, and no response in 20%. No significant difference was detected between imiquimod and tazarotene groups (P=0.190).
CONCLUSIONS
Compared to imiquimod, tazarotene 0.1% gel for the treatment of plane warts seems to offer equivalent treatment response, maintained efficacy without recurrence, safer profile regarding dyspigmentation with an advantageous cheaper cost.
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Additional Info
Tazarotene is as effective and tolerable as imiquimod in the treatment of verruca plana, a comparative randomized clinical trial
Clin Exp Dermatol 2024 Apr 15;[EPub Ahead of Print], H Nofal, F Omran, B ElKholy, S Nofal, A NofalFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Although other topical retinoids have long been used to treat warts (including plane warts), this is the first report of using tazarotene for that purpose.
The authors assessed outcomes in 60 patients receiving treatment for 12 weeks, randomized into three groups: nightly application of imiquimod 5% cream, tazarotene 0.1% gel, or placebo. The percentage of patients achieving complete clearance was slightly, but not statistically significantly, higher in the imiquimod group (50%) than in the tazarotene group (40%). Similarly, multiple other clinical measures showed statistically significant improvements in both active treatment groups when compared with placebo, but the differences between the active arms were not statistically significant. The average time to reach complete clearance was about 9 weeks in both groups, and patients with complete clearance had no recurrence during a 6-month follow-up period. Local side effects were mild and temporary, and they were mostly reported during the first month of treatment. The overall frequency of side effects was comparable in the two active treatment arms, but hypopigmentation was only reported in the imiquimod group. Based on comparisons with prior publications, the authors suggested that tazarotene may be superior to other topical retinoids in terms of overall efficacy, lack of dyspigmentation, and no lesion recurrence for 6 months after treatment.
These results suggest that topical tazarotene may be a good alternative to imiquimod, especially when treating persons of color, to avoid the risk of imiquimod-associated vitiligo-like hypopigmentation. If used, frequent but mild side effects can be expected, especially during the first month. Tazarotene should be tried for at least 9 weeks before declaring treatment failure. Head-to-head comparisons are needed to confirm whether tazarotene offers efficacy or tolerability advantages over other topical retinoids, and further studies should determine whether using tazarotene in combination with other modalities improves its efficacy.