[Optimal use guide: pharmacological treatment of sexually transmitted and blood-borne infections ─ external condylomas (anogenital warts)]

Record ID 32018000991
Original Title: Guide usage optimal: traitement pharmacologique des infections transmissibles sexuellement et par le sang – condylomes externes (verrues anogénitales)
Authors' objectives: In 2012, the Institut national d'excellence en santé et en services sociaux (INESSS) published a series of five optimal use guides (OUGs) on the pharmacological treatment of sexually transmitted and blood-borne infections (STBBI). One of these five guides concerns condylomas, which are associated with human papillomavirus (HPV) infection. INESSS's objective was to completely update the OUG entitled Pharmacological treatment: STBBI – Condylomas (genital warts) by means of a systematic literature review.
Authors' results and conclusions: RESULTS: Minor changes were made to the OUG as the result of this update. The sections General Considerations, Clinical Manifestations and Management were made more detailed and clearer, and a subsection on natural history was added to round out the information. Among the elements to be taken into consideration when deciding whether or not to treat external condylomas are psychological distress, which they cause in some individuals, and the adverse effects associated with the treatment. Furthermore, the section on preventive measures has been linked to those in the following OUGs on the pharmacological treatment of STBBI published by INESSS in 2018: STBBI – Syndromic Approach and STBBI – Uncomplicated Chlamydia trachomatis or Neisseria gonorrhoeae infection. The main change is the addition of a therapeutic option, namely, sinecatechins 10% ointment, to the existing arsenal. The three sets of CPGs consulted recommend applying the ointment thrice daily for a maximum of 16 weeks. The British Association for Sexual Health and Human Immunodeficiency Virus (HIV) (BASHH), whose guidelines were among those consulted, reports efficacy similar to that of the other therapeutic options. Lastly, on the subject of vaccination, in addition to the types of vaccines available, and like the Protocole d'immunisation du Québec (PIQ), information was added stipulating that vaccines have a certain degree of efficacy against reinfections by the HPVs included in them. CONCLUSION: This update of the OUG on the pharmacological treatment of STBBI, ITSS − Condylomes externes (verrues anogénitales), was carried out to ensure that the recommendations reflect the best practices. The information and the clinical recommendations mainly concern the general considerations regarding external condylomas, the clinical manifestations, management, treatment principles, and follow-up. This OUG will serve to guide and support health professionals’ practice in order to optimize the management of patients with external condylomas.
Authors' methods: This update is based on the best available scientific data and on recommendations in clinical practice guidelines (CPGs) of good methodological quality, which were enriched with experiential knowledge from different experts and clinicians, and with legislative and organizational contextual elements specific to Québec, including government publications from the Institut national de santé publique du Québec (INSPQ) and the Ministère de la Santé et des Services sociaux (MSSS).
Project Status: Completed
Year Published: 2019
English language abstract: An English language summary is available
Publication Type: Other
Country: Canada
Province: Quebec
MeSH Terms
  • Condylomata Acuminata
  • Sexually Transmitted Diseases, Viral
  • Papillomavirus Infections
  • Warts
  • Drug Therapy
  • Drug Therapy, Combination
  • Antiviral Agents
  • Practice Guidelines as Topic
Organisation Name: Institut national d'excellence en sante et en services sociaux
Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name: demande@inesss.qc.ca
Contact Email: demande@inesss.qc.ca
Copyright: L'Institut national d'excellence en santé et en services sociaux (INESSS)
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