Fit Kathy E, Williams Patrick C
Department of Pharmacy Practice, Midwestern University Chicago College of Pharmacy, Downers Grove, IL 60515, USA.
Ann Pharmacother. 2007 Jul;41(7):1222-6. doi: 10.1345/aph.1H616. Epub 2007 May 29.
To review the evidence for histamine2 (H2)-antagonists in the treatment of common warts.
Relevant publications were identified through a systematic search of PubMed English-language literature using the MeSH terms and key words cimetidine, ranitidine, famotidine, nizatidine, histamine H2-antagonists, and warts. Additional articles were identified using the same key words in the Cochrane Database and International Pharmaceutical Abstracts. Systematic searches were conducted through January 2007. In addition, pertinent references from identified articles were reviewed.
The literature search retrieved 21 relevant citations, excluding review articles. Five open-label studies and 7 randomized controlled clinical trials were evaluated. Cimetidine was the focus of 11 studies, and ranitidine was evaluated in 1 study. No data regarding the other H2-antagonists were found. The other retrieved citations were not evaluated due to their design (case reports or case series) and/or focus on specific wart subtypes, not common warts.
The use of H2-antagonists in the treatment of common warts is not associated with significant improvements in resolution rates. Open-label studies were promising with an estimated 48-81% response rate. However, randomized controlled trials have failed to show significant efficacy when cimetidine was compared with placebo or topical agents, and ranitidine has never been evaluated in a randomized controlled trial. Adverse effects, specifically gastrointestinal complaints, were documented. Efficacy may have been limited by inadequate dosing in some of the trials. The studies were limited by the small sample size and lack of power in a number of the trials, as well as the documented spontaneous resolution rate for warts.
Several open-label trials evaluating the use of H2-antagonists for verruca vulgaris reported high response rates, but these results have not been corroborated by more rigorous clinical trials. Current data do not support the use of H2-antagonists for the treatment of common warts.
综述组胺2（H2）受体拮抗剂治疗寻常疣的证据。
通过使用医学主题词（MeSH）和关键词西咪替丁、雷尼替丁、法莫替丁、尼扎替丁、组胺H2受体拮抗剂和疣，对PubMed英文文献进行系统检索，确定相关出版物。在考克兰数据库和国际药学文摘中使用相同关键词确定其他文章。检索截至2007年1月。此外，对已确定文章的相关参考文献进行了综述。
文献检索共检索到21篇相关文献，不包括综述文章。评估了5项开放标签研究和7项随机对照临床试验。11项研究聚焦于西咪替丁，1项研究评估了雷尼替丁。未找到关于其他H2受体拮抗剂的数据。其他检索到的文献因设计（病例报告或病例系列）和/或聚焦于特定疣亚型而非寻常疣，未进行评估。
使用H2受体拮抗剂治疗寻常疣，治愈率并无显著提高。开放标签研究显示出一定前景，估计有效率为48% - 81%。然而，将西咪替丁与安慰剂或外用药物比较时，随机对照试验未显示出显著疗效，雷尼替丁从未在随机对照试验中进行评估。记录了不良反应，尤其是胃肠道不适。部分试验中疗效可能因给药不足而受限。这些研究因样本量小、多项试验缺乏检验效能以及记录的疣自发消退率而受到限制。
几项评估H2受体拮抗剂治疗寻常疣的开放标签试验报告了较高的有效率，但这些结果未得到更严格临床试验的证实。目前的数据不支持使用H2受体拮抗剂治疗寻常疣。
