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Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study

Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision...

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Autores principales: Hendriks, Natasja, Koeneman, Margot M., van de Sande, Anna J.M., Penders, Charlotte G.J., Piek, Jurgen M.J., Kooreman, Loes F.S., van Kuijk, Sander M.J., Hoosemans, Linde, Sep, Simone J.S., de Vos Van Steenwijk, Peggy J., van Beekhuizen, Heleen J., Slangen, Brigitte F.M., Nijman, Hans W., Kruitwagen, Roy F.P.M., Kruse, Arnold-Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906243/
https://www.ncbi.nlm.nih.gov/pubmed/35180719
http://dx.doi.org/10.1097/CJI.0000000000000414
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author Hendriks, Natasja
Koeneman, Margot M.
van de Sande, Anna J.M.
Penders, Charlotte G.J.
Piek, Jurgen M.J.
Kooreman, Loes F.S.
van Kuijk, Sander M.J.
Hoosemans, Linde
Sep, Simone J.S.
de Vos Van Steenwijk, Peggy J.
van Beekhuizen, Heleen J.
Slangen, Brigitte F.M.
Nijman, Hans W.
Kruitwagen, Roy F.P.M.
Kruse, Arnold-Jan
author_facet Hendriks, Natasja
Koeneman, Margot M.
van de Sande, Anna J.M.
Penders, Charlotte G.J.
Piek, Jurgen M.J.
Kooreman, Loes F.S.
van Kuijk, Sander M.J.
Hoosemans, Linde
Sep, Simone J.S.
de Vos Van Steenwijk, Peggy J.
van Beekhuizen, Heleen J.
Slangen, Brigitte F.M.
Nijman, Hans W.
Kruitwagen, Roy F.P.M.
Kruse, Arnold-Jan
author_sort Hendriks, Natasja
collection PubMed
description Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN.
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spelling pubmed-89062432022-03-10 Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study Hendriks, Natasja Koeneman, Margot M. van de Sande, Anna J.M. Penders, Charlotte G.J. Piek, Jurgen M.J. Kooreman, Loes F.S. van Kuijk, Sander M.J. Hoosemans, Linde Sep, Simone J.S. de Vos Van Steenwijk, Peggy J. van Beekhuizen, Heleen J. Slangen, Brigitte F.M. Nijman, Hans W. Kruitwagen, Roy F.P.M. Kruse, Arnold-Jan J Immunother Clinical Studies Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN. Lippincott Williams & Wilkins 2022-04 2022-02-17 /pmc/articles/PMC8906243/ /pubmed/35180719 http://dx.doi.org/10.1097/CJI.0000000000000414 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Clinical Studies
Hendriks, Natasja
Koeneman, Margot M.
van de Sande, Anna J.M.
Penders, Charlotte G.J.
Piek, Jurgen M.J.
Kooreman, Loes F.S.
van Kuijk, Sander M.J.
Hoosemans, Linde
Sep, Simone J.S.
de Vos Van Steenwijk, Peggy J.
van Beekhuizen, Heleen J.
Slangen, Brigitte F.M.
Nijman, Hans W.
Kruitwagen, Roy F.P.M.
Kruse, Arnold-Jan
Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study
title Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study
title_full Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study
title_fullStr Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study
title_full_unstemmed Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study
title_short Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study
title_sort topical imiquimod treatment of high-grade cervical intraepithelial neoplasia (topic-3): a nonrandomized multicenter study
topic Clinical Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906243/
https://www.ncbi.nlm.nih.gov/pubmed/35180719
http://dx.doi.org/10.1097/CJI.0000000000000414
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