HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial
Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based o...
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creator | Bruggink, Sjoerd C Gussekloo, Jacobijn de Koning, Maurits N.C Feltkamp, Mariet C.W Bavinck, Jan Nico Bouwes Quint, Wim G.V Assendelft, Willem J.J Eekhof, Just A.H |
description | Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care. |
doi_str_mv | 10.1016/j.jcv.2013.02.021 |
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Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care.</description><identifier>ISSN: 1386-6532</identifier><identifier>EISSN: 1873-5967</identifier><identifier>DOI: 10.1016/j.jcv.2013.02.021</identifier><identifier>PMID: 23518443</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; Allergy and Immunology ; Child ; Child, Preschool ; Cryotherapy - methods ; Cutaneous warts ; DNA, Viral - genetics ; Drug Therapy - methods ; Female ; Foot Diseases - therapy ; Foot Diseases - virology ; Genotype ; Human papillomavirus (HPV) ; Humans ; Infectious Disease ; Male ; Middle Aged ; Netherlands ; Papillomaviridae - classification ; Papillomaviridae - genetics ; Papillomaviridae - isolation & purification ; Papillomavirus Infections - therapy ; Papillomavirus Infections - virology ; Salicylic Acid - administration & dosage ; Treatment ; Treatment Outcome ; Warts - therapy ; Warts - virology ; Young Adult</subject><ispartof>Journal of clinical virology, 2013-07, Vol.57 (3), p.227-232</ispartof><rights>Elsevier B.V.</rights><rights>2013 Elsevier B.V.</rights><rights>Copyright © 2013 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-572ecfe1cc3239567d457283d2bb6c1c6ed1912b342bfd2aff43371908c9a9e33</citedby><cites>FETCH-LOGICAL-c451t-572ecfe1cc3239567d457283d2bb6c1c6ed1912b342bfd2aff43371908c9a9e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcv.2013.02.021$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23518443$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bruggink, Sjoerd C</creatorcontrib><creatorcontrib>Gussekloo, Jacobijn</creatorcontrib><creatorcontrib>de Koning, Maurits N.C</creatorcontrib><creatorcontrib>Feltkamp, Mariet C.W</creatorcontrib><creatorcontrib>Bavinck, Jan Nico Bouwes</creatorcontrib><creatorcontrib>Quint, Wim G.V</creatorcontrib><creatorcontrib>Assendelft, Willem J.J</creatorcontrib><creatorcontrib>Eekhof, Just A.H</creatorcontrib><title>HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial</title><title>Journal of clinical virology</title><addtitle>J Clin Virol</addtitle><description>Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Allergy and Immunology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cryotherapy - methods</subject><subject>Cutaneous warts</subject><subject>DNA, Viral - genetics</subject><subject>Drug Therapy - methods</subject><subject>Female</subject><subject>Foot Diseases - therapy</subject><subject>Foot Diseases - virology</subject><subject>Genotype</subject><subject>Human papillomavirus (HPV)</subject><subject>Humans</subject><subject>Infectious Disease</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands</subject><subject>Papillomaviridae - classification</subject><subject>Papillomaviridae - genetics</subject><subject>Papillomaviridae - isolation & purification</subject><subject>Papillomavirus Infections - therapy</subject><subject>Papillomavirus Infections - virology</subject><subject>Salicylic Acid - administration & dosage</subject><subject>Treatment</subject><subject>Treatment Outcome</subject><subject>Warts - therapy</subject><subject>Warts - virology</subject><subject>Young Adult</subject><issn>1386-6532</issn><issn>1873-5967</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1rFTEUHUSxtfoD3EiWbuaZj5nMjIJQilqh0EKr25BJ7kDGvGRMMpW36l_3Dq-6cCFcSLicc7jnnKp6zeiOUSbfzbvZ3O84ZWJHOQ57Up2yvhN1O8juKf5FL2vZCn5Svch5ppS1oumeVydctKxvGnFaPVzefCflsABxgSxeh6IT-aVTybiY_ArBQCZBlzVpT0xcUwaigyUlgS57CIUkyEsMGd6TWzAxWJ0OiND-kF0mcSKaJCTEvctgUSGUFL2HTcFp_7J6Nmmf4dXje1Z9-_zp7uKyvrr-8vXi_Ko2TctK3XYczATMGMHF0MrONrjqheXjKA0zEiwbGB9Fw8fJcj1NjRAdG2hvBj2AEGfV26PukuLPFXJReI8Bj44hrlkx0UrRUdpIhLIj1KSYc4JJLcnt0ZViVG25q1lh7mrLXVGOw5Dz5lF-Hfdg_zL-BI2AD0cAoMl7B0ll47ZwrUtgirLR_Vf-4z9s411wRvsfcIA8Yy0YOLpQGQnqdit-650JSmnPpfgNLm-qJQ</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Bruggink, Sjoerd C</creator><creator>Gussekloo, Jacobijn</creator><creator>de Koning, Maurits N.C</creator><creator>Feltkamp, Mariet C.W</creator><creator>Bavinck, Jan Nico Bouwes</creator><creator>Quint, Wim G.V</creator><creator>Assendelft, Willem J.J</creator><creator>Eekhof, Just A.H</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial</title><author>Bruggink, Sjoerd C ; Gussekloo, Jacobijn ; de Koning, Maurits N.C ; Feltkamp, Mariet C.W ; Bavinck, Jan Nico Bouwes ; Quint, Wim G.V ; Assendelft, Willem J.J ; Eekhof, Just A.H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-572ecfe1cc3239567d457283d2bb6c1c6ed1912b342bfd2aff43371908c9a9e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Allergy and Immunology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cryotherapy - methods</topic><topic>Cutaneous warts</topic><topic>DNA, Viral - genetics</topic><topic>Drug Therapy - methods</topic><topic>Female</topic><topic>Foot Diseases - therapy</topic><topic>Foot Diseases - virology</topic><topic>Genotype</topic><topic>Human papillomavirus (HPV)</topic><topic>Humans</topic><topic>Infectious Disease</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands</topic><topic>Papillomaviridae - classification</topic><topic>Papillomaviridae - genetics</topic><topic>Papillomaviridae - isolation & purification</topic><topic>Papillomavirus Infections - therapy</topic><topic>Papillomavirus Infections - virology</topic><topic>Salicylic Acid - administration & dosage</topic><topic>Treatment</topic><topic>Treatment Outcome</topic><topic>Warts - therapy</topic><topic>Warts - virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bruggink, Sjoerd C</creatorcontrib><creatorcontrib>Gussekloo, Jacobijn</creatorcontrib><creatorcontrib>de Koning, Maurits N.C</creatorcontrib><creatorcontrib>Feltkamp, Mariet C.W</creatorcontrib><creatorcontrib>Bavinck, Jan Nico Bouwes</creatorcontrib><creatorcontrib>Quint, Wim G.V</creatorcontrib><creatorcontrib>Assendelft, Willem J.J</creatorcontrib><creatorcontrib>Eekhof, Just A.H</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bruggink, Sjoerd C</au><au>Gussekloo, Jacobijn</au><au>de Koning, Maurits N.C</au><au>Feltkamp, Mariet C.W</au><au>Bavinck, Jan Nico Bouwes</au><au>Quint, Wim G.V</au><au>Assendelft, Willem J.J</au><au>Eekhof, Just A.H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial</atitle><jtitle>Journal of clinical virology</jtitle><addtitle>J Clin Virol</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>57</volume><issue>3</issue><spage>227</spage><epage>232</epage><pages>227-232</pages><issn>1386-6532</issn><eissn>1873-5967</eissn><abstract>Abstract Background Cryotherapy is effective for common warts, but for plantar warts available treatments often fail. Objectives Within a pragmatic randomised controlled trial, we examined whether subgroups of common and plantar warts have a favourable natural course or response to treatment based on wart-associated HPV type. Study design Consecutive patients with new common or plantar warts were recruited in 30 Dutch family practices. Patients ( n = 250) were randomly allocated to liquid-nitrogen cryotherapy, 40% salicylic acid self-application, or wait-and-see policy. Before treatment, swabs were taken from all separate warts and analysed by a broad spectrum HPV genotyping assay. At 13 weeks, cure rates with 95% confidence intervals of common and plantar warts on intention to treat basis were compared between treatment arms for the different wart-associated HPV types. Results In total, 7% of swabs tested negative for HPV DNA and 16% contained multiple types, leaving 278 of 371 common swabs (75%) and 299 of 373 plantar swabs (80%) with a single type for analysis. After wait-and-see policy, cure rates were 2/70 (3%, 95% confidence interval 1–10) for HPV 2/27/57-associated common warts, 4/58 (7%, 3–16) for HPV 2/27/57-associated plantar warts, and 21/36 (58%, 42–73) for HPV 1-associated plantar warts. After cryotherapy, cure rates were 30/44 (68%, 53–80), 6/56 (11%, 5–21), and 15/23 (65%, 45–81); after salicylic acid 16/87 (18%, 12–28), 15/60 (25%, 16–37), and 24/26 (92%, 76–98), respectively. Conclusions HPV type influenced the natural course and response to treatment for plantar warts. HPV testing potentially optimises wart treatment in primary care.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>23518443</pmid><doi>10.1016/j.jcv.2013.02.021</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Aged Allergy and Immunology Child Child, Preschool Cryotherapy - methods Cutaneous warts DNA, Viral - genetics Drug Therapy - methods Female Foot Diseases - therapy Foot Diseases - virology Genotype Human papillomavirus (HPV) Humans Infectious Disease Male Middle Aged Netherlands Papillomaviridae - classification Papillomaviridae - genetics Papillomaviridae - isolation & purification Papillomavirus Infections - therapy Papillomavirus Infections - virology Salicylic Acid - administration & dosage Treatment Treatment Outcome Warts - therapy Warts - virology Young Adult |
title | HPV type in plantar warts influences natural course and treatment response: Secondary analysis of a randomised controlled trial |
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