Imiquimod is an immune response modifier. It induces cytokines that promote a TH1 lymphocyte or cell-mediated immune response.43-45 These cytokines include interferon alpha and gamma, and interleukin (IL)-12. In animal studies, imiquimod has demonstrated broad antiviral and antitumor effects that are largely mediated by interferon alfa.44 In humans, imiquimod 5% cream is safe and effective in the treatment of external anogenital warts.47-48 We found six RCTs, summarised in Table 26.7.

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