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A randomized controlled proof-of-concept trial of digoxin and furosemide in adults with cutaneous warts.

ABSTRACT: BACKGROUND:Topical ionic contraviral therapy (ICVT) with digoxin and furosemide inhibits the potassium influx on which DNA viruses rely for replication. Therefore, ICVT was hypothesized to be a potential novel treatment for cutaneous warts. OBJECTIVES:To assess the clinical efficacy, safety and tolerability of ICVT in adults with cutaneous warts. The secondary objective was to gain insight into the underlying working mechanism of ICVT. METHODS:Treatment with ICVT was assessed for efficacy, safety and tolerability in a single- centre, randomized, double-blind, placebo-controlled phase IIA trial. Eighty adult patients with at least two cutaneous warts (plantar or common) were randomized to one of four treatments: digoxin + furosemide (0·125%), digoxin (0·125%), furosemide (0·125%) or placebo. The gel was administered once daily for 42 consecutive days. Predefined statistical analysis was performed with a mixed-model ancova. The trial was registered at ClinicalTrials.gov with number NCT02333643. RESULTS:Wart size and human papillomavirus (HPV) load reduction was achieved in all active treatment groups. A statistically significant reduction in wart diameter of all treated warts was shown in the digoxin + furosemide treatment group vs. placebo (-3·0 mm, 95% confidence interval -4·9 to -1·1, P = 0·002). There was a statistically significant reduction in the HPV load of all treated warts in the digoxin + furosemide group vs. placebo (-94%, 95% confidence interval -100 to -19, P = 0·03). With wart size reduction, histologically and immunohistochemically defined viral characteristics disappeared from partial and total responding warts. CONCLUSIONS:This study demonstrates the proof of concept for the efficacy of topical ICVT in adults with cutaneous warts.

SUBMITTER: Rijsbergen M

PROVIDER: S-EPMC6850412 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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A randomized controlled proof-of-concept trial of digoxin and furosemide in adults with cutaneous warts.

Rijsbergen M M Niemeyer-van der Kolk T T Hogendoorn G G Kouwenhoven S S Lemoine C C Klaassen E S ES de Koning M M Beck S S Bouwes Bavinck J N JN Feiss G G Burggraaf J J Rissmann R R

The British journal of dermatology 20190307 5

<h4>Background</h4>Topical ionic contraviral therapy (ICVT) with digoxin and furosemide inhibits the potassium influx on which DNA viruses rely for replication. Therefore, ICVT was hypothesized to be a potential novel treatment for cutaneous warts.<h4>Objectives</h4>To assess the clinical efficacy, safety and tolerability of ICVT in adults with cutaneous warts. The secondary objective was to gain insight into the underlying working mechanism of ICVT.<h4>Methods</h4>Treatment with ICVT was assess ...[more]

PMID: 30580460

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Dataset Information

A randomized controlled proof-of-concept trial of digoxin and furosemide in adults with cutaneous warts.

Publications

A randomized controlled proof-of-concept trial of digoxin and furosemide in adults with cutaneous warts.

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