PATIENT-APPLIED TREATMENT FOR GENITAL WARTS - EXPERIENCE FROM A LARGEPOSTMARKETING STUDY

OBJECTIVE TO determine the safety, efficacy, and acceptability of self -administered podofilox for treatment of genital warts when used, in e veryday circumstances. DESIGN Prospective cohort study. SETTING Nation al convenience sample of 1361 patients enrolled through 453 physicians who frequently treat genital warts, PATIENTS Serial enrollment of pat ients being treated for the first time or who had completed another tr eatment with unsatisfactory results. After initial examination, patien ts used podofilox for up to four cycles (each consisting of 3 days of treatment, 4 days without), At the end of each week, patients complete d a diary detailing response and symptoms. After 4 weeks, patients ret urned to the physician for reevaluation. Brief follow-up questionnaire s were also obtained 8 and 12 weeks after initiating therapy. RESULTS At 4 weeks, the end of the main evaluation period, 53% of patients rep orted complete clearing, and another 28% clearing of at least half the ir warts. The most common side-effects were pain and burning, and redn ess and smelling, Side-effects were most frequent and most severe duri ng the first week of use, Overall assessment by physicians and patient s was favorable, with 65% and 70%, respectively, considering podofilox to be better than other treatments. Patient comments indicated that a n advantage of podofilox treatment was that repeated physician visits were unnecessary. CONCLUSIONS In typical conditions of use among large numbers of subjects, podofilox is effective and well tolerated. The s trongest virtue of self-treatment with podofilox may be that it offers a less costly and more flexible method of treatment, a benefit of par ticular interest for managed care settings.