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Cimetidine and Placebo Work Equally Well for Warts

Multiple or recalcitrant warts can be a vexing problem. Previous research suggests that three months of cimetidine therapy may be useful. Two recent studies evaluated the effectiveness of cimetidine for treating warts.

In a placebo-controlled study from Turkey, 28 patients with at least five warts each received cimetidine (25 to 40 mg/kg daily), divided into three or four doses, for three months and 26 received placebo. The mean age of the patients was 15 years in the cimetidine group and 15.8 years in the placebo group. Patients had the warts for an average of 2.5 years. Cure rates in the two groups were not significantly different: 32% with cimetidine and 30.7% with placebo. For patients under age 16, the cure rates were 52.9% and 53.3%, respectively. The authors conclude that cimetidine is ineffective for the treatment of viral warts.

In an open-label study from the U.S., 20 adults with recalcitrant warts (present for more than 2 years) were treated with cimetidine (30 to 40 mg/kg daily) for three months. Warts resolved completely in 12 of the 18 patients (67%) who completed the study. No clinical adverse events or laboratory abnormalities were noted. The authors conclude that cimetidine is a potentially useful therapy for warts but caution that placebo-controlled trials are needed.

Comment: Reports of the usefulness of cimetidine were well covered in the lay press, and many parents brought articles to my attention. The Turkish study confirms my belief that a placebo can be wonderful when treating a child with multiple warts. For warts, cimetidine is no better than placebo, but placebo helped more than half of the children in this study. The decision is which placebo to use and when.

The cure rates in the U.S. study are impressive, even better than those in the Turkish study. The main difference between the two may be in patient selection: unlike the placebo-controlled trial, the open-label study did not require a minimum of five warts. Placebo-controlled trials are useful, especially for warts. Taken together, the studies suggest that cimetidine may not be better than placebo, but in the hands of the believer it may be a very potent placebo.

— NH Shear

Published in Journal Watch Dermatology July 1, 1996

Citation(s):

Yilmaz E et al. Cimetidine therapy for warts: A placebo-controlled, double-blind study. J Am Acad Dermatol 1996 34 1005-1007.

• Medline abstract (Free)

Glass AT; Solomon BA. Cimetidine therapy for recalcitrant warts in adults. Arch Dermatol 1996 132 680-682.

• Medline abstract (Free)

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