Off-label study: short-course imiquimod for VAIN treatment.(News)

LAKE BUENA VISTA, FLA. -- Initial clinical experience in treating vaginal intraepithelial neoplasia with topical imiquimod has shown short-course therapy to have a high degree of efficacy, simplicity of use, and a relative absence of associated adverse events. Dr. Henry W. Buck reported.

A series of 84 patients from a student health service now has been treated for vaginal intraepithelial neoplasia (VAIN) with the topical immune response modifier, Dr. Buck said at a meeting of the American Society for Colposcopy and Cervical Pathology.

The treatment course involves the internal application of one sachet of imiquimod 5% cream (250 mg) once weekly for three doses. The first dose is given in the office, and patients administer the subsequent doses themselves, said Dr. Buck of the University of Kansas, Lawrence.

Of 67 who completed the treatment with imiquimod (Aldara) and were available for follow-up, 54 (81%) cleared with one course of therapy.

Of the remaining 13, 10 cleared after two courses.

Most (79) patients had low-grade disease (VAIN-1). Three had diagnoses of VAIN-2, and two had VAIN-3.

One VAIN-2 patient cleared after a single course, another after three courses, and the third was lost to follow-up. Both of the two VAIN-3 patients cleared after one ...