Imiquimod for Cervical and Vaginal Intraepithelial Neoplasia

    July 2023 in “ Obstetrics & Gynecology
    Yoshihide Inayama, Shiro Takamatsu, Junzo Hamanishi, Kayoko Mizuno, Noboru Horinouchi, Koji Yamanoi, Mana Taki, Ryusuke Murakami, Ken Yamaguchi, Kenzo Kosaka, Orestis Efthimiou, Koji Kawakami, Toshi A Furukawa, Masaki Mandai
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    TLDR Imiquimod may be a better non-surgical treatment for cervical pre-cancer, but its effectiveness for vaginal pre-cancer is unclear, and it has some side effects.
    The systematic review and meta-analysis evaluated the effectiveness and side effects of imiquimod, a topical medication, for treating Cervical Intraepithelial Neoplasia (CIN) and Vaginal Intraepithelial Neoplasia (VAIN). The study found that imiquimod is potentially a superior alternative to surgery for CIN, with a pooled odds ratio (OR) for histologic regression of 4.27 (95% CI 2.11–8.66). However, data on its effectiveness for VAIN was inconclusive. Adverse events were common, but less than 10% of patients discontinued treatment, indicating that imiquimod is generally well-tolerated. Three cases of temporary hair loss were reported, but it was reversible in all cases. The study recommends further research to optimize imiquimod administration and manage adverse events.
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