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Sodium Nitrate Citric Acid Effective for Anogenital Warts

High-dose treatment linked to improvement in complete clinical clearance at 12 weeks

THURSDAY, April 30, 2015 (HealthDay News) -- For patients with anogenital warts, high-dose topical treatment (sodium nitrite, 6 percent, with citric acid, 9 percent) is more effective than placebo, according to a study published online April 29 in JAMA Dermatology.

Anthony D. Ormerod, M.D., from the University of Aberdeen in the United Kingdom, and colleagues examined the efficacy of the topical application of nitric oxide delivered using acidified nitrite. Participants included 299 volunteers, aged older than 18 years, with between two and 50 external anogenital warts, who were randomized to a control arm and a treatment arm. Patients in the treatment arm received three doses of acidified nitrite (low dose, middle dose, and high dose) applied topically for 12 weeks.

The researchers found that complete clinical clearance at 12 weeks occurred in 14, 15, 23, and 31 percent of patients treated with placebo and low-, middle-, and high-dose treatment, respectively. The superiority of high-dose treatment versus placebo was seen for reduction in target wart area, time to clearance, and patient and investigator assessments. No systematic or serious adverse events were seen in association with treatment. Active treatment was associated with a dose-related increase in itching, pain, edema, and staining of the anogenital skin.

"Use of sodium nitrite, 6 percent, with citric acid, 9 percent, twice daily is more effective than placebo in the treatment of anogenital warts," the authors write.

Several authors disclosed financial ties to ProStrakan, which funded the study. Support was also provided by Origin Pharmaceuticals. Two authors have filed patents on acidified nitrite.

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