Poster Spotlight: H2 Receptor Antagonists and Verruca Plantaris
As part of our coverage of the research emerging from the APMA National, Podiatry Today had a chance to touch down with Porscha Dort, DPM, about her team’s inquiry into a treatment option for plantar warts, and what the current research reveals.
Can you share a bit about the origination of this poster and your reason for undertaking this research?
The idea for this research stemmed from a clinical encounter with a patient who had persistent plantar warts. Despite undergoing various treatments options, including salicylic acid, cantharidin, and even surgical intervention, she found no relief. The patient inquired about oral treatment options, which lead Dr. Susek and I to explore the potential use of H2 receptor antagonists for treatment. We found that these systemic agents have been noted for their immunomodulatory properties when used in high doses, often employed in treating hypersecretory conditions. Intrigued by these potential benefits, we decided to investigate further, hoping to find a new approach for treating the patient’s stubborn plantar warts.
How did you conduct this research, and what were your primary findings?
To conduct this research, we performed a systematic review and meta-analysis. We searched databases like Medline, OVID, and Embase up to January 2024, focusing on studies involving H2 receptor antagonists (such as cimetidine, ranitidine, famotidine, and nizatidine) specifically for plantar warts. Following PRISMA guidelines, we included studies that directly assessed the use of these agents for plantar warts and excluded those examining other body areas.
Out of an initial 112 studies, we included 4 studies with a total of 178 participants. The primary findings were mixed. We observed some studies indicating significant improvement with combination therapy of 2 different H2 antagonists, while others showed partial or complete response rates compared to placebo. However, we noted that one study found no significant difference between H2 antagonist treatment and placebo. Overall, the evidence was inconclusive, suggesting that more research is needed to establish the efficacy of H2 receptor antagonists for plantar warts.
What do you hope DPMs can learn from you and your colleagues’ work, and what do you feel might be some future research opportunities in this area?
Our research highlights the potential of H2 receptor antagonists as a treatment option for plantar warts, especially for cases resistant to conventional therapies. We hope that DPMs can take away a broader perspective on managing these lesions, considering both traditional and novel treatments.
Future research opportunities include conducting larger, placebo-controlled clinical trials to definitively assess the efficacy of H2 receptor antagonists. Understanding the mechanisms behind their immunomodulatory effects could also lead to more targeted therapies. Additionally, exploring combination therapies and prophylactic measures, such as the HPV vaccine, could offer more comprehensive management strategies for plantar warts. Our study underscores the importance of continuing to investigate and expand treatment options to improve patient outcomes in podiatric medicine.
Dr. Dort is a third-year podiatric medicine and surgery resident in Northeastern Pennsylvania.
1. Dort P, Nasser EM, Susek M. H2 Receptor Antagonist for Treatment of Plantar Warts: A Meta-Analysis. Poster presented at APMA National. August 8-11, 2024. Washington, DC.
