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Esperienze Dermatologiche 2016 September-December;18(3-4):199-209

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Meta-analysis of randomized controlled trials evaluating a novel therapy of Bacille Calmette-Guerin polysaccharide nucleic acid combined with CO2 laser for condyloma acuminatum patients

Yang SUN 1, Fei WU 2, Xinyu LI 1, Heng GU 1

1 Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China; 2 Department of Urology, Huashan Hospital, Fudan University, Shanghai, China


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INTRODUCTION: Condyloma acuminatum (CA) caused by anogenital human papillomavirus (HPV) infection is prevalent around the world. However, the current management for CA remains unsatisfactory.
EVIDENCE ACQUISITION: Electronic literature databases (MEDLINE, Cochrane, Embase, China National Knowledge Infrastructure, and Wanfang database) were searched for relevant randomized controlled trials (RCT). A meta-analysis and subgroup analysis were performed to pool the data. Bias was excluded by funnel plot and Egger’s test. In addition, sensitivity test was used to increase the stability and reliability of our study.
EVIDENCE SYNTHESIS: Twenty-three articles including 25 RCTs were included and strictly evaluated by the previous protocols. The major findings of the current meta-analysis provided evidence that application of BCG-PSN after CO2 laser had a lower recurrence rate than CO2 laser alone within 3 months (OR:0.26, 95% CI: 0.21-0.31); comparing with a single dose of 0.5 mg, the administration of BCG-PSN 1.0 mg at one time during the course of treatment did not decrease the recurrence risk significantly; the comparison between low total dose (<10 mg) group and moderate total dose (10-20 mg) group was also insignificant; but the OR of high-total dose (>20 mg) group is higher than the low total dose (<10 mg) group.
CONCLUSIONS: Application of CO2 laser combined with BCG-PSN is an effective and safe methods of treatment with a lower recurrence rate for CA. Low single (0.5 mg) and total dose (<10 mg) appear to be sufficient to reach a satisfactory prevention efficacy for recurrence.

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