| NET STUDY
|Year : 2017 | Volume
| Issue : 3 | Page : 411-
Immunotherapy in viral warts with intradermal Bacillus Calmette–Guerin vaccine versus intradermal tuberculin purified protein derivative: A double-blind, randomized controlled trial comparing effectiveness and safety in a tertiary care center in Eastern India
Indrashis Podder1, Sabari Bhattacharya1, Vivek Mishra1, Tushar Kanti Sarkar1, Somodyuti Chandra1, Amrita Sil2, Santasmita Pal3, Dhiraj Kumar1, Abanti Saha1, Koushik Shome1, Debabrata Bandyopadhyay1, Nilay Kanti Das1
1 Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
2 Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
3 Department of Biochemistry, Medical College and Hospital, Kolkata, West Bengal, India
Background: Current therapeutic modalities for viral warts are mostly ablative and are limited by high recurrence rates besides being unsuitable for numerous lesions. Immunotherapy has the potential to overcome these limitations.
Aims: The aim of this study was to compare the effectiveness and safety of Bacillus Calmette–Guerin vaccine versus tuberculin purified protein derivative in the immunotherapy of warts.
Methods: Patients received three doses of 0.1 ml of Bacillus Calmette–Guerin vaccine or tuberculin purified protein derivative intradermally over the deltoid region at 4-weekly intervals. They were followed-up for another month. Number of warts, complete cure rates and quality of life were assessed.
Results: A total of 60 patients were included. Complete clearance was noted in 16 (48.5%) out of 33 patients in the Bacillus Calmette–Guerin group and in 5 (18.5%) out of 27 in the tuberculin purified protein derivative group (P = 0.121). The number of lesions reduced statistically significantly from baseline in both the groups (P < 0.001) from the first follow-up visit onward (P < 0.05). The reduction was statistically significantly more in the Bacillus Calmette–Guerin group than in the tuberculin purified protein derivative group from the second follow-up onward. Dermatologic life quality index improved statistically significantly with both treatments. Adverse events (pain during injection, abscess formation and scarring at injection site) were more frequent with Bacillus Calmette–Guerin. No recurrence was seen after lesions cleared.
Limitations: Patients were not followed up for more than 4 weeks after treatment. We could not estimate the cytokine levels or the peripheral blood mononuclear cell proliferation in response to Bacillus Calmette–Guerin/tuberculin purified protein derivative injections.
Conclusion: Both intradermal Bacillus Calmette–Guerin and tuberculin purified protein derivative hold promise in the treatment of viral warts. Bacillus Calmette–Guerin may be more effective, though it had more adverse events in our study.
Dr. Nilay Kanti Das
Department of Dermatology, Medical College and Hospital, 88, College Street, Kolkata - 700 073, West Bengal
Source of Support: None, Conflict of Interest: None
Clinical trial registration CTRI/2014/12/005244
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