Intralesional measles-mumps-rubella is associated with a higher complete response in cutaneous warts: a systematic review and meta-analysis of randomized controlled trial including GRADE qualification.

Abstract

INTRODUCTION:

Warts can be difficult to treat and progressing to chronic and resistant disease. Several studies have reported the successful application of mumps-measles-rubella (MMR) vaccine resulting in clearance of warts via immunomodulation and induction of immune system.

METHODS:

We performed a comprehensive search on the role of intralesional MMR in warts from several electronic databases. Complete response is defined as complete clearance of warts lesion.

RESULTS:

There were a total of 425 subjects from five studies. Intralesional injection of MMR was associated with an increased complete response (OR 9.43 [5.78, 15.37], p < .001; I2: 5%, p = .38). Subgroup analysis on patients receiving injection for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [6.40, 21.38], p < .001; I2: 20%, p = .29. Patients receiving intralesional MMR were associated with a lower partial response (OR 0.54 [0.33, 0.88], p = .01; I2: 0%, p = .66). Intralesional MMR was associated with a reduced no-response (OR 0.16 [0.06, 0.43], p < .001; I2: 69%, p = .01). Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias. There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord's test (p = .047). Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000.

CONCLUSION:

Intralesional MMR injection was associated with a higher complete response and lower no-response with a high level of certainty.

• Authors: Rachel Vania, Raymond Pranata, Sukmawati Tansil Tan
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 32 Issue 8 Pg. 1010-1017 (Dec 2021) ISSN: 1471-1753 [Electronic] England
• PMID: 31985307 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Measles-Mumps-Rubella Vaccine

Topics

• Humans
• Injections, Intralesional
• Measles
• Measles-Mumps-Rubella Vaccine (therapeutic use)
• Mumps
• Randomized Controlled Trials as Topic
• Rubella
• Warts (drug therapy)