Rijsbergen Melanie, Rijneveld Rianne, Todd Marina, Feiss Gary L, Kouwenhoven Stijn T P, Quint Koen D, van Alewijk Dirk C J G, de Koning Maurits N C, Klaassen Erica S, Burggraaf Jacobus, Rissmann Robert, van Poelgeest Mariëtte I E
Centre for Human Drug Research, Leiden, the Netherlands.
Cutanea Life Sciences, Wayne, Pennsylvania, USA.
Br J Clin Pharmacol. 2020 Nov;86(11):2133-2143. doi: 10.1111/bcp.14181. Epub 2020 Sep 28.
To assess safety and tolerability and explore pharmacodynamics and efficacy of omiganan in external anogenital warts (AGW) and vulvar high-grade squamous intraepithelial lesions (HSIL).
Two randomized controlled trials in patients with external AGW and vulvar HSIL were conducted. Patients received topical omiganan 2.5% or placebo gel once daily for 12 weeks with a follow-up of 12 weeks. Safety and tolerability were monitored and pharmacodynamics and clinical efficacy of omiganan were assessed by analysing lesion count, size and viral load. Self-reported pain, itch and quality of life were assessed by an electronic diary and questionnaire.
Twenty-four AGW and 12 vulvar HSIL patients were enrolled. All patients had a high treatment adherence (99%). No serious adverse events occurred and all adverse events (n = 27) were mild, transient and self-limiting. The treatment groups were not different in terms of safety and tolerability, lesion count and size, and patient-reported outcomes pain, itch and quality of life. Human papillomavirus load significantly reduced after 12 weeks of treatment with omiganan compared to placebo (-96.6%; 95% confidence interval -99.9 to -7.4%; P = .045) in AGW patients only.
Topical omiganan appears to be safe in patients with AGW and vulvar HSIL and reduced human papillomavirus load after 12 weeks of treatment in AGW patients.
评估奥米加南治疗外生殖器肛门疣(AGW)和外阴高级别鳞状上皮内病变(HSIL)的安全性、耐受性,并探索其药效学及疗效。
针对外生殖器肛门疣患者和外阴HSIL患者开展了两项随机对照试验。患者每日一次外用2.5%奥米加南或安慰剂凝胶,持续12周,并随访12周。监测安全性和耐受性,通过分析病灶数量、大小及病毒载量评估奥米加南的药效学和临床疗效。通过电子日记和问卷评估自我报告的疼痛、瘙痒及生活质量。
纳入24例AGW患者和12例外阴HSIL患者。所有患者治疗依从性高(99%)。未发生严重不良事件,所有不良事件(n = 27)均为轻度、短暂且自限性的。治疗组在安全性、耐受性、病灶数量和大小以及患者报告的疼痛、瘙痒和生活质量方面无差异。仅在AGW患者中,与安慰剂相比,奥米加南治疗12周后,人乳头瘤病毒载量显著降低(-96.6%;95%置信区间-99.9至-7.4%;P = 0.045)。
外用奥米加南对于AGW和外阴HSIL患者似乎是安全的,且在AGW患者治疗12周后可降低人乳头瘤病毒载量。