WEDNESDAY, April 2 (HealthDay News) -- An imiquimod cream is effective in treating vulvar intraepithelial neoplasia, reducing lesion size, itching and pain, according to a report in the April 3 issue of the New England Journal of Medicine.

Manon van Seters, M.D., from Erasmus University Medical Center in Rotterdam, the Netherlands, and colleagues randomly assigned 52 patients with grade 2 or 3 vulvar intraepithelial neoplasia to a placebo or 5 percent imiquimod cream (Aldara, 3M Pharmaceuticals) applied twice a week for 16 weeks.

The researchers found that at 20 weeks, significantly more patients treated with imiquimod had a reduction in lesion size of more than 25 percent (81 percent versus 0 percent), with significantly greater histologic regression. Nearly all patients were positive for human papillomavirus at baseline, with significantly greater clearance of the virus in the imiquimod group (58 percent versus 8 percent). Imiquimod increased the number of immune epidermal cells, decreased the number of immune dermal cells, and reduced pruritis and pain, the investigators report. Nine patients, all of whom received imiquimod, had a complete response at 20 weeks and remained disease-free at 12 months.

"Imiquimod is effective in the treatment of vulvar intraepithelial neoplasia," van Seters and colleagues conclude.

The study medication was provided by 3M Pharmaceuticals, who also performed the randomization.

Abstract
Full Text (subscription or payment may be required)