Background: (1) Salicylic acid (SA) and 5-Fluorouracil (5-FU) are effective drugs in wart therapy. (2) In Germany, increasing data on the benefit and the economic efficiency of drugs at Level I of evidence-based medicine are needed.
Methods: Evaluation of the effectiveness and benefits of a drug combination containing 0.5 % 5-FU and 10% SA in the therapy of (a) common and (b) plantar warts in form of a two-step procedure--(1) Systematic literature analysis, (2) Meta-analysis of the randomised-controlled studies (RCTs).
Results: (1) The efficacy of 5-FU/SA therapy was tested in a total of 625 patients (n=8 RCTs) with common warts and 101 patients (n=4 RCTs) with plantar warts. The therapeutic effect across all studies in common warts was 63.4% response (complete healing) for 5-FU/SA vs. 23.1% for the 5-FU-free controls, respectively. In plantar warts, the response was 63.0% vs. 11.0%. (2) A meta-analysis of n=7 RCTs on common warts (n=325 patients) showed a mean risk difference of 0.42 (CI 0.34-0.50, p < 0.05), thus a significant superiority of 5-FU/SA over SA. A comparable result was also found for plantar warts.
Conclusion: The combination of 5-FU and SA is an effective and beneficial therapy for common and plantar warts.