Different possibilities based on a patient’s unique needs

Dr. RosenDepending on the medical specialist caring for patients with human papillomavirus (HPV), traditional treatments for genital warts tend to fall into two general categories: provider-administered and patient-administered therapies, according to Theodore Rosen, M.D., chief of the dermatology service at Michael E. DeBakey Veterans Affairs Medical Center and professor of dermatology at Baylor College of Medicine in Houston.

The problem for providers and their patients is that many traditional treatments for genital warts are uncomfortable, challenging for patients and embarrassing. The disease, itself, is emotionally and socially difficult.

Among the patient-administered therapies: podophyllotoxin, sinecatechins ointment or several versions of imiquimod cream.

“All of these treatments are generally more comfortable than physician-administered therapies, and all of them permit the emotional comfort of privacy.”

There is hope of a new option-a topical treatment in the pipeline called SB206 (Novan). Novan announced last November that SB206 had achieved statistically significant results for the treatment of HPV-induced genital warts.

“We know that nitric oxide is effective against HPV-induced genital warts, but it is also destructive. … SB206 places a nitric oxide mechanism of action inside a carrier molecule. Patients apply the topical gel, which slowly releases the gas, destroying the wart by destroying the causative HPV virus,” says Dr. Rosen, who is a member of Novan’s advisory board.

In phase 2 clinical trials, researchers looked at SB206 in three concentrations. Patients who used the highest concentration of 12%, once daily, experienced good tolerability and the best results. In 12 weeks, 42.1% of patients were completely clear, according to Dr. Rosen.

“These results, although not derived from a full phase 3 study, are very encouraging,” he says. “I view SB206 as a potentially easier, more comfortable option for these patients. I am closely watching for the phase 3 clinical trials that are planned for later this year.” ƒ

Disclosure: Dr. Rosen is a member of Novan’s advisory council.