Efficacy of inosine pranobex as an adjuvant oral therapy in anogenital warts

Background: Human papillomavirus (HPV) cause the most prevalent sexually transmitted infection and is an important etiological factor in genital cancer development. HPV infection manifest in broad spectrum, from genital warts to cervical intraepithelial neoplasia and cancers. Genital warts remain a frequent problem primary care. Current modalities for curing genital warts gives unsatisfactory result in curing the genital warts totally. To date, there are many convincing studies which encourage oral inosine pranobex as an adjuvant treatment to improve post-conventional therapy cure-rate.  Method: Literature searching was done using Pubmed, Ebsco and Science Direct database. Inclusion criterias were human subject, randomized controlled trial study, patient with genital warts, and inosine pranobex as adjuvant therapy. The studies were appraised and findings were formulated to find the best evidence for collating recommendations in treating genital warts patients Results: There were three articles relating the clinical questions. All articles are found to be valid after selection based on exclusion and inclusion criterias. Discussion: All articles recommend the addition of oral inosine pranobex as an adjuvant therapy in treating patient with genital warts. Based on the critical appraisal done previously, addition of oral inosine pranobex may minimize conventional therapy failure (ARR 0.54(0.42-0.66), 0.28 (0.21- 0.35) and 0.23 (0.03 – 0.43)). (NNT 2(1,5-2,4), 4(2,9-4,8) and 4(2,3-3,3)). Conclusions: Based on the best evidence available, we would recommend the addition of oral inosine pranobex as adjuvant for treating the genital warts, except in special conditions, such as financial problem as this therapy was not covered by Indonesian public health insurance.