Antiviral agents for the treatment of recurrent respiratory papillomatosis: a systematic review of the English-language literature.
OBJECTIVE
To determine the efficacy of antiviral agents for recurrent respiratory papillomatosis (RRP) in children and adults.


METHODS
Systematic review to include randomized controlled trials (RCTs), comparative studies (historical and/or nonrandomized), case series, and case reports.


RESULTS
Twenty-six original studies were included (one case-control series, 21 noncomparative trials, four case reports, and no RCTs). Meta-analysis was not possible. The antiviral modalities included acyclovir, ribavirin, intravenous cidofovir, and intralesional cidofovir injections. The strongest evidence was for intralesional cidofovir, with 17 studies including 158 patients. Of these, 90 patients (57%) demonstrated complete resolution, 55 patients (35%) a partial response, and 13 patients (8%) showed no improvement.


CONCLUSIONS
Insufficient evidence from controlled trials exists for reliable conclusions, but several series indicate intralesional cidofovir may have some efficacy. A well-designed placebo-controlled, double-blinded, randomized controlled trial is needed.


CONCLUSIONS
This study provides the background for future study design and a comprehensive review of the available evidence.
Chadha
Neil K
NK
Department of ENT Otolaryngology-Head and Neck Surgery, Torbay Hospital, Torquay, Devon, United Kingdom. neil@chadhanet.com
James
Adrian L
AL
D000998:Antiviral Agents / Q000627:therapeutic use*; D000077404:Cidofovir; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D063065:Organophosphonates / Q000627:therapeutic use; D010039:Otorhinolaryngologic Neoplasms / Q000188:drug therapy*; D010212:Papilloma / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir