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Has anyone heard of any scientific based research that advocates the use of tagamet (usually reserved for duodenal ucers) in the treatment of recalcitrent warts.
Better still has anyone had experince in using it?
Can cimetidine therapy effectively stimulate the body’s immune response against warts? Several clinicians have anecdotally reported success using cimetidine against warts. Previous double-blind studies comparing cimetidine with placebo therapy have failed to statistically and scientifically corroborate those results. Between 1995 and 2002, 216 patients underwent an isolated course of oral cimetidine therapy for verruca plantaris. Our treatment outcomes closely parallel those obtained by other researchers. Cimetidine may be used as a safe, effective, lone treatment modality for verruca in all age groups.
BACKGROUND: Common warts, or verrucae vulgaris, occur most often in children. However, many adults are plagued by this ubiquitous viral infection. Various modalities have been used to treat warts, but none is uniformly effective or directly antiviral. A recent study showed cimetidine to be effective in the treatment of multiple warts in children. Anecdotal reports have suggested that the administration of high doses of cimetidine, through various proposed immunomodulating mechanisms, can improve recalcitrant warts in adults. There have been no data published to date supporting these claims. OBSERVATIONS: An open-label study was conducted to determine the safety and efficacy of high-dose cimetidine in 20 adult patients with recalcitrant warts. Of the 18 patients who completed the study, 16 patients (84%) had either dramatic clinical improvement or complete resolution of their wart lesions after 3 months of cimetidine therapy without any adverse effects. No patient demonstrated disease progression while receiving the medication and complete responders remained free of lesions at 1-year follow-up. CONCLUSIONS: This study further confirms that high-dose cimetidine therapy appears to be beneficial and safe in the treatment of recalcitrant warts in adults. Further placebo-controlled studies are needed to determine its true efficacy.
Three open-label, uncontrolled studies have documented successful treatment of warts with cimetidine, whereas two placebo-controlled, double-blind studies and two open-label comparative trials have failed to demonstrate efficacy. This double-blind, placebo-controlled study was designed with stringent enrollment and outcome criteria to minimize the confounding issue of spontaneous remission. Efficacy was not statistically superior to that of placebo, but a trend toward efficacy was suggested for younger subjects.
Last edited by Admin : 7th March 2006 at 03:48 AM.
Dear LCG,
I have seen cimetidine used once in this way.
An 11 year old boy with mosaic vp covering most of both plantar surfaces whom I referred to the dermatologist. Response was both rapid and positive, and to my knowledge, there has been no recurrence (this all happened 5 years ago).
This said, I have never understood the mechanism of how an H2 receptor antagonist helped in the treatment of vps.
Regards,Poll.
__________________
If you are on the rollercoaster, open your eyes and enjoy the ride.
Only last Monday I had a patient come to my clinic saying the Dermatologists had suggested Cimetidine for treatment of VP's. She did say however they were a little off-hand and not very convincing about its effectiveness.
Will pass on the above info to the lady concerned, and keep you posted regarding results.
But used it on a 20 year old micro biologist UK student in the USA with 'success', (wrote it up but did not publish, now doing PHD) and a 23 year old air hostess.
Both had access to cheap unlimited supply.
I am interested in Imiquimod, the Germans have done some work, but like cimetidine, not licenced so it's over to the Uni's, unless we 'workers' can get organised to do some trials.
As a private practitioner I get very frustrated about the lack of access to 'science'.
Barry R. Mullen, John V. Guiliana, and Fawaz Nesheiwat. Letter to the Editor: Cimetidine as a First-Line Therapy for Pedal Verruca: Authors’ ResponseJ Am Podiatr Med Assoc 2005 95: 508-a
Thanks for that, a very interesting discussion and probably way beyond my BSc stats.
However I have done a Google search on Cemitidine and come up with Dermatology On Line Journal Vol ( number 2.
What a confusing picture? :(
I am prepared to be shot down in flames, but as far as I can See a lot of the 'gold standard' trials are on very small (though statistically significant) populations.
In a previous life I was a work study engineer, (long obsolete) knew nothing but trained to challenge 'everything'.
What I find most interesting in any study are the 'exceptions/ failures' the extremes of the statistical analysis. There must be a reason for them?
I have yet to see a study showing 100% resolution of a VP by a treatment,
Can I question whether we are always asking the right question or examining the outcomes of our trials correctly? Are the 'trials' too simplistic to investigate 'complex' situations.
Please do not crucify me I'm only a chiropodist, but like many others, (including the Bio men) we see the results but cannot prove them.
Bob
Sorry forgot to mention the significant point about this thread 'First line treatment'.
Certainly in the UK not an option, but what is the 'first line treatment'? Any comments
Some of my patients have used Cimetidine (Tagamet) in the treatment of verrucae. This has been used in a dosage of 2 - 3 x 400mg tablets per day. Sometimes it has been used in conjunction with zinc tablets and others with the application of Glutarol.
With lesions, which have survived for up to four years, there has been a marked improvement within 3 weeks - 3 months. I only use this treatment with female patients, due to the tendency of male patients to develop breast tissue with this medication.
Anne
Last edited by Anne McLean : 24th May 2006 at 09:56 AM.
Tagamet (cimetidine) for wart treatment
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