Intralesional injection of mumps-measles-rubella vaccine is associated with a higher complete response in cutaneous warts

Objectives:
Is intralesional injection of mumps-measles-rubella (MMR) vaccine associated with a higher complete response in cutaneous warts?

Study design:
This review article included 5 RCTs with a total of 425 subjects.

Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias.
There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord's test (p = 0.047).
Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000.

Results and conclusions:
The investigators found intralesional injection of mumps-measles-rubella (MMR) vaccine was associated with an increased complete response [OR = 9.43, 95% CI = 5.78 to 15.37, p 0.001, I2 = 5%, p = 0.38].

The investigators found subgroup analysis on patients receiving injection of mumps-measles-rubella (MMR) vaccine for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [95% CI = 6.40, 21.38, p 0.001, I2 = 20%, p = 0.29].

The investigators found patients receiving intralesional mumps-measles-rubella (MMR) vaccine were associated with a lower partial response [OR = 0.54, 95% CI = 0.33 to 0.88, p = 0.01, I2 = 0%, p = 0.66].

The investigators found intralesional mumps-measles-rubella (MMR) vaccine was associated with a reduced no-response [OR = 0.16, 95% CI = 0.06 to 0.43, p 0.001, I2 = 69%, p = 0.01].

The investigators concluded intralesional MMR injection is associated with a higher complete response and lower no-response with a high level of certainty.

Original title:
Intralesional Measles-Mumps-Rubella Is Associated With a Higher Complete Response in Cutaneous Warts: A Systematic Review and Meta-Analysis of Randomized Controlled Trial Including GRADE Qualification by Vania R, Raymond Pranata R and Tan ST.

Link:
https://pubmed.ncbi.nlm.nih.gov/31985307/

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