Meta-análisis del uso de la inosina pranobex para el tratamiento de verrugas anogenitales
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Fecha
2023
Tipo
tesis
Autores
Báez Vásquez, María Fernanda
Rodríguez Chavarría, Jose Luis
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El virus de papiloma humano (VPH), primero fue descrito como “virus de verrugas humanas”, implicado en la patogénesis de verrugas genitales. El VPH puede ser considerado la infección de transmisión sexual (ITS) más común en la población general. Más de 100 subtipos de VPH han sido identificados; de los cuales, 40 infectan el área anogenital. Se dividen en tipos de alto y bajo riesgo, los de bajo riesgo son mayormente asociados con verrugas anogenitales y otras enfermedades benignas. Existe amplia evidencia que apoya la hipótesis de que el estado inmunológico del huésped y los cambios inmunológicos inducidos por VPH son responsables de la infección persistente. El sistema inmune reconoce y elimina el virus mediante inmunidad celular y humoral, los cuales son vitales para el aclaramiento de la infección por VPH. La inmunoterapia es una modalidad de tratamiento esencial para infecciones microbianas, malignidades y otras patologías. La inosina pranobex, un agente inmunomodulador, se ha utilizado para el tratamiento de los estados de deficiencia inmunológica relacionados con diversas infecciones virales. Su mecanismo de acción se relaciona con la capacidad de agilizar acciones inmunitarias lentas, aumentar los efectos citotóxicos de los linfocitos T y las células asesinas naturales. El objetivo de este metaanálisis es evaluar la efectividad del Isoprinosine (inosina pranobex) en el tratamiento de pacientes con verrugas genitales. Métodos: Búsquedas electrónicas en la Biblioteca Cochrane, MEDLINE, EMBASE y LILACS, para ensayos controlados aleatorizados (ECA) donde se compara el Isoprinosine con otros tratamientos o con placebo. Resultados: Se obtuvo un riesgo relativo (RR) de 1.15 intervalo de confianza (IC) 95% (0.66 - 2.00) a las 12 semanas, no mostrando diferencia entre los grupos para la eliminación total de las verrugas. Encontramos un RR de 1.37 IC 95% (0.98 - 1.92) a las 12 semanas, no mostrando diferencia entre los grupos en la respuesta parcial de verrugas a las 12 semanas de seguimiento. Conclusión: Es justificable realizar ensayos grandes y con diseños dirigidos a minimizar los riesgos de sesgo en los resultados, debido a que en la actualidad el uso de inosina pranobex está ampliamente generalizado en la región sin un soporte científico concluyente
Human papillomavirus (HPV), first described as "human wart virus", is implicated in the pathogenesis of genital warts. HPV can be considered the most common sexually transmitted infection (STI) in the general population. More than 100 HPV subtypes have been identified; of which, 40 infect the anogenital area. They are divided into high-risk and low-risk types, with low-risk ones being mostly associated with anogenital warts and other benign diseases. There is evidence supporting the hypothesis that the immunological status of the host and HPV-induced immunological changes are responsible for persistent infection. The immune system recognizes and eliminates the virus through cellular and humoral immunity, both of which are vital for the clearance of HPV infection. Immunotherapy is an essential treatment modality for microbial infections, malignancies, and other pathologies. Inosine pranobex, an inmunomodulating agent, has been used for the treatment of immune deficiency states associated with various viral infections. Its mechanism of action is related to the ability to speed up slow immune actions, increase the cytotoxic effects of T lymphocytes and NK natural killer cells. The objective of this meta-analysis is to evaluate the effectiveness of Isoprinosine (inosine pranobex) in the treatment of patients with genital warts. Methods: electronic searches in the Cochrane Library, MEDLINE, EMBASE and LILACS, for randomized controlled trials (RCTs) comparing Isoprinosine with other treatments or with placebo. Results: A RR of 1.15 CI 95% (0.66 - 2.00) was obtained at 12 weeks, showing no difference between the groups for healing, total elimination of warts. We found a RR of 1.37 95% CI (0.98 - 1.92) at 12 weeks, showing no difference between groups in wart partial response at 12-week followup. Conclusion: It is justifiable to carry out large trials with designs aimed at minimizing the risks of bias in the results, since the use of inosine pranobex is currently very widespread in the region without conclusive scientific support.
Human papillomavirus (HPV), first described as "human wart virus", is implicated in the pathogenesis of genital warts. HPV can be considered the most common sexually transmitted infection (STI) in the general population. More than 100 HPV subtypes have been identified; of which, 40 infect the anogenital area. They are divided into high-risk and low-risk types, with low-risk ones being mostly associated with anogenital warts and other benign diseases. There is evidence supporting the hypothesis that the immunological status of the host and HPV-induced immunological changes are responsible for persistent infection. The immune system recognizes and eliminates the virus through cellular and humoral immunity, both of which are vital for the clearance of HPV infection. Immunotherapy is an essential treatment modality for microbial infections, malignancies, and other pathologies. Inosine pranobex, an inmunomodulating agent, has been used for the treatment of immune deficiency states associated with various viral infections. Its mechanism of action is related to the ability to speed up slow immune actions, increase the cytotoxic effects of T lymphocytes and NK natural killer cells. The objective of this meta-analysis is to evaluate the effectiveness of Isoprinosine (inosine pranobex) in the treatment of patients with genital warts. Methods: electronic searches in the Cochrane Library, MEDLINE, EMBASE and LILACS, for randomized controlled trials (RCTs) comparing Isoprinosine with other treatments or with placebo. Results: A RR of 1.15 CI 95% (0.66 - 2.00) was obtained at 12 weeks, showing no difference between the groups for healing, total elimination of warts. We found a RR of 1.37 95% CI (0.98 - 1.92) at 12 weeks, showing no difference between groups in wart partial response at 12-week followup. Conclusion: It is justifiable to carry out large trials with designs aimed at minimizing the risks of bias in the results, since the use of inosine pranobex is currently very widespread in the region without conclusive scientific support.
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Virus de papiloma humano, Isoprinosine, Verrugas, ginecología, SALUD DE LA MUJER