Efficacy

Conflicting results were reported in five RCTs of intralesional bleomycin. Cure rates ranged from

16% to 94%. Two trials35,36 showed higher cure rates with bleomycin than with placebo, one37 showed placebo to achieve higher cure rates than bleomycin and one38 showed no significant difference between bleomycin and placebo. One other trial found no significant difference in cure rates between three different concentrations of bleomycin injections.39

Bleomycin versus placebo

One RCT35 using a left-right design in 24 adults showed cure rates of 58% and 10% of warts with

0-1% bleomycin and saline (placebo) injections, respectively. Another RCT36 in 16 adults and children showed cure rates of 82% and 35% of warts with 0-1% bleomycin and saline injections, respectively. Yet another RCT37 in 62 adults achieved cure rates of 16% and 44% with 1% bleomycin in oil or saline, and oil or saline placebo injections, respectively. A further RCT38 in 31 adults and children showed cure rates of 94% and 73% of participants with 0-1% bleomycin and saline injections respectively.

Different concentrations of bleomycin

One RCT39 in 26 adults comparing 0-25, 0-5 and

1-0 units/ml bleomycin showed cure rates of 73%, 88% and 90% of warts, respectively; differences were not statistically significant.

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