A high-dose treatment of sodium nitrite and citric acid creams applied twice daily was more effective than placebo for treating anogenital warts, according to a new study in JAMA Dermatology.

Anthony D. Ormerod, MD, of the University of Aberdeen, Scotland, and colleagues conducted a four-arm trial of 299 individuals who were assigned to three acidified nitrite interventions (ranging in dose) or placebo. Because citric acid reacts with nitrite to form the active molecule when mixed, the sodium nitrite cream was applied first. The doses were the following:

  • Sodium nitrite 3% and citric acid 4.5%, creams applied twice daily (low dose)
  • Sodium nitrite 6% and citric acid 9% creams applied once daily at night with placebo in the morning (middle dose)
  • Sodium nitrite 6% and citric acid 9% creams applied twice daily (high dose)
  • Sodium nitrite placebo with citric acid placebo twice daily (placebo)

Complete clinical clearance at 12 weeks was found in 14% of patients in the placebo group, 15% in the low dose group, 23% in the middle dose group, and 31% in the high dose group. A dose-related increase in itching, pain, edema, and staining of the anogenital skin was associated with active treatment.

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Because the lower doses were not more efficacious than placebo, additional research is merited on the efficacy of the high dose treatment for the treatment of anogenital warts, the study concluded.

For more information visit JAMANetwork.com.