Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
Department of Dermatovenerology, Faculty of Medicine, Universitas Tarumanegara, Jakarta, Indonesia.
J Dermatolog Treat. 2021 Dec;32(8):1010-1017. doi: 10.1080/09546634.2020.1716931. Epub 2020 Jan 27.
Warts can be difficult to treat and progressing to chronic and resistant disease. Several studies have reported the successful application of mumps-measles-rubella (MMR) vaccine resulting in clearance of warts immunomodulation and induction of immune system.
We performed a comprehensive search on the role of intralesional MMR in warts from several electronic databases. Complete response is defined as complete clearance of warts lesion.
There were a total of 425 subjects from five studies. Intralesional injection of MMR was associated with an increased complete response (OR 9.43 [5.78, 15.37], < .001; : 5%, = .38). Subgroup analysis on patients receiving injection for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [6.40, 21.38], < .001; : 20%, = .29. Patients receiving intralesional MMR were associated with a lower partial response (OR 0.54 [0.33, 0.88], = .01; : 0%, = .66). Intralesional MMR was associated with a reduced no-response (OR 0.16 [0.06, 0.43], < .001; : 69%, = .01). Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias. There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord's test ( = .047). Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000.
Intralesional MMR injection was associated with a higher complete response and lower no-response with a high level of certainty.
疣很难治疗，并且可能发展为慢性和耐药疾病。几项研究报告了麻疹-腮腺炎-风疹（MMR）疫苗的成功应用，导致疣清除、免疫调节和免疫系统的诱导。
我们从多个电子数据库中对 MMR 瘤内注射在疣中的作用进行了全面检索。完全缓解定义为疣病变完全清除。
共有来自五项研究的 425 名受试者。MMR 瘤内注射与完全缓解率增加相关（OR9.43[5.78,15.37]， < .001； = 5%， = .38）。对每 2 周接受注射治疗、最多接受 5 次注射的患者进行亚组分析，发现 OR 为 11.70[6.40,21.38]， < .001； = 20%， = .29。接受 MMR 瘤内注射的患者发生部分缓解的可能性较低（OR0.54[0.33,0.88]， = .01； = 0%， = .66）。MMR 瘤内注射与无反应的风险降低相关（OR0.16[0.06,0.43]， < .001； = 69%， = .01）。完全缓解的漏斗图分析呈不对称性，表明存在发表偏倚的风险。使用 Harbord 检验分析 MMR 瘤内注射对完全缓解的影响时，存在统计学意义的小样本效应（ = .047）。推荐评估、制定与评价（GRADE）评估显示，在疣中，MMR 瘤内注射对完全缓解的疗效具有高度确定性（证据质量），每 1000 人中绝对增加 505 例。
MMR 瘤内注射与较高的完全缓解率和较低的无反应率相关，具有高度确定性。
