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<p>Cutaneous warts are common, and conventional destructive therapies have high recurrence rates and side effects. Intralesional immunotherapy with MMR vaccine and vitamin D has emerged as a promising alternative; however, its comparative efficacy remains unknown. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to compare the efficacy and safety of intralesional MMR versus intralesional vitamin D for the treatment of cutaneous warts. A comprehensive search of PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar was conducted for RCTs up to October 2025. The primary outcome was the clinical response of injected warts. Secondary outcomes included distant wart response, recurrence, and adverse events. Risk ratios (RRs) were pooled using STATA 19.5, along with 95% confidence intervals (CIs). Fifteen RCTs involving 1,144 patients were included. Intralesional MMR vaccine significantly increased the rate of complete clinical response in injected warts compared to vitamin D (RR: 1.16, 95% CI [1.07, 1.27]; <i>p</i> = 0.001). However, no significant differences were found for partial response in injected warts (RR: 0.92, 95% CI [0.70, 1.22]; <i>p</i> = 0.58), distant wart response (<i>p</i> = 0.26), or recurrence (<i>p</i> = 0.06). Regarding safety, the MMR vaccine was associated with significantly lower rates of injection site swelling (RR: 0.36, 95% CI [0.26, 0.49]; <i>p</i> &lt; 0.001) and erythema (RR: 0.63, 95% CI [0.43, 0.91]; <i>p</i> = 0.02), with no difference in pain (<i>p</i> = 0.17). Intralesional MMR vaccine may improve the complete response of injected warts compared with intralesional vitamin D, with lower rates of some local adverse events. However, no clear differences were observed in distant wart response or recurrence, and the findings should be interpreted cautiously due to methodological concerns and clinical heterogeneity across the included trials.</p>

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Efficacy of intralesional MMR vaccine and vitamin D for cutaneous warts: a systematic review and meta-analysis of randomized controlled trials

  • 期刊论文

  • 发表日期：

    2026年7月28日

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  • Abdullah M. Alharran,
  • Retaj S. AlJuma,
  • Rashed A. Alhusaini,
  • Sarah M. Sabzali,
  • Fai Mubarak Alsaleeli,
  • Danah I. Alkandari,
  • Shouq Alkhatlan,
  • Sayed Hashim,
  • Suad Alassaf,
  • Deemah I. Alkandari,
  • Ali Ashkanani

摘要

Cutaneous warts are common, and conventional destructive therapies have high recurrence rates and side effects. Intralesional immunotherapy with MMR vaccine and vitamin D has emerged as a promising alternative; however, its comparative efficacy remains unknown. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to compare the efficacy and safety of intralesional MMR versus intralesional vitamin D for the treatment of cutaneous warts. A comprehensive search of PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar was conducted for RCTs up to October 2025. The primary outcome was the clinical response of injected warts. Secondary outcomes included distant wart response, recurrence, and adverse events. Risk ratios (RRs) were pooled using STATA 19.5, along with 95% confidence intervals (CIs). Fifteen RCTs involving 1,144 patients were included. Intralesional MMR vaccine significantly increased the rate of complete clinical response in injected warts compared to vitamin D (RR: 1.16, 95% CI [1.07, 1.27]; p = 0.001). However, no significant differences were found for partial response in injected warts (RR: 0.92, 95% CI [0.70, 1.22]; p = 0.58), distant wart response (p = 0.26), or recurrence (p = 0.06). Regarding safety, the MMR vaccine was associated with significantly lower rates of injection site swelling (RR: 0.36, 95% CI [0.26, 0.49]; p < 0.001) and erythema (RR: 0.63, 95% CI [0.43, 0.91]; p = 0.02), with no difference in pain (p = 0.17). Intralesional MMR vaccine may improve the complete response of injected warts compared with intralesional vitamin D, with lower rates of some local adverse events. However, no clear differences were observed in distant wart response or recurrence, and the findings should be interpreted cautiously due to methodological concerns and clinical heterogeneity across the included trials.