Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Clin Microbiol Infect. 2019 Feb;25(2):210-216. doi: 10.1016/j.cmi.2018.04.012. Epub 2018 Apr 21.
To evaluate the efficacy of a carrageenan-based lubricant gel in reducing the risk of genital human papillomavirus (HPV) infections in women.
We conducted a planned interim analysis of a randomized, double-blind, placebo-controlled, phase 2B trial. Women aged 18 years and older were randomly assigned (1:1) to a carrageenan-based gel or a placebo gel to be self-applied every other day for the first month and before and after each intercourse during follow-up. Assessments were performed at 0.5, 1, 3, 6, 9 and 12 months. The primary outcome was incidence of a new infection by an HPV type that was not present at baseline. Intention-to-treat analyses were performed.
Between January 2013 and June 2017, a total of 280 participants were randomly assigned to the carrageenan (n = 141) or the placebo (n = 139) arm. All participants were included in safety analyses, but three (1%) were excluded from efficacy analyses (HPV results unavailable for two participants in the carrageenan and one participant in the placebo arm). The median follow-up time was 9.2 months (interquartile range, 1.9-13.2 months). A total of 59 (42%) of 139 participants in the carrageenan arm and 78 (57%) of 138 participants in the placebo arm became infected by at least one new HPV type (hazard ratio = 0.64, 95% confidence interval = 0.45-0.89, p 0.009). A total of 62 (44%) of 141 participants in the carrageenan arm versus 43 (31%) of 139 participants in the placebo arm reported an adverse event (p 0.02), none of which was deemed related to the gels.
Our trial's interim analysis suggests that using a carrageenan-based lubricant gel can reduce the risk of genital HPV infections in women.
评估角叉菜聚糖基润滑剂凝胶降低女性生殖器人乳头瘤病毒(HPV)感染风险的效果。
我们对一项随机、双盲、安慰剂对照、2B 期临床试验进行了计划中的中期分析。18 岁及以上的女性被随机分配(1:1)接受角叉菜聚糖基凝胶或安慰剂凝胶,在前一个月每隔一天自我应用一次,在随访期间每次性交前和后应用。评估在 0.5、1、3、6、9 和 12 个月时进行。主要结局是新感染基线时不存在的 HPV 类型的发生率。进行意向治疗分析。
2013 年 1 月至 2017 年 6 月,共有 280 名参与者被随机分配至角叉菜聚糖组(n=141)或安慰剂组(n=139)。所有参与者均纳入安全性分析,但有 3 名(1%)被排除在疗效分析之外(角叉菜聚糖组的 2 名参与者和安慰剂组的 1 名参与者 HPV 结果不可用)。中位随访时间为 9.2 个月(四分位间距,1.9-13.2 个月)。角叉菜聚糖组的 139 名参与者中共有 59 名(42%)和安慰剂组的 138 名参与者中共有 78 名(57%)感染了至少一种新的 HPV 类型(风险比=0.64,95%置信区间=0.45-0.89,p=0.009)。角叉菜聚糖组的 141 名参与者中共有 62 名(44%)和安慰剂组的 139 名参与者中共有 43 名(31%)报告了不良事件(p=0.02),但均与凝胶无关。
我们的试验中期分析表明,使用角叉菜聚糖基润滑剂凝胶可以降低女性生殖器 HPV 感染的风险。