Imiquimod

Source: Wikipedia, the free encyclopedia.

Imiquimod
Clinical data
Trade namesAldara, others[1]
Other names1-isobutyl-1H-imidazo[4,5-c]quinolin-4-amine
AHFS/Drugs.comMonograph
MedlinePlusa698010
License data
Pregnancy
category
Topical
ATC code
Legal status
Legal status
Pharmacokinetic data
Elimination half-life30 hours (topical dose), 2 hours (subcutaneous dose)
Identifiers
  • 3-(2-Methylpropyl)-3,5,8-triazatricyclo[7.4.0.02,6]trideca-1(9),2(6),4,7,10,12-hexaen-7-amine
JSmol)
  • n3c1ccccc1c2c(ncn2CC(C)C)c3N
  • InChI=1S/C14H16N4/c1-9(2)7-18-8-16-12-13(18)10-5-3-4-6-11(10)17-14(12)15/h3-6,8-9H,7H2,1-2H3,(H2,15,17) checkY
  • Key:DOUYETYNHWVLEO-UHFFFAOYSA-N checkY
  (verify)

Imiquimod, sold under the brand name Aldara among others, is a

basal cell carcinoma, and actinic keratosis.[4]

Scientists at 3M's pharmaceuticals division discovered the drug and 3M obtained the first FDA approval in 1997. As of 2015, imiquimod is generic and is available worldwide under many brands. In 2021, it was the 290th most commonly prescribed medication in the United States, with more than 600,000 prescriptions.[5][6]

Medical uses

Imiquimod is a patient-applied cream prescribed to treat

basal cell carcinoma,[7][8] as well as actinic keratosis.[9]

Imiquimod 5% cream is indicated for the topical treatment of:

  • external genital and perianal warts (condylomata acuminata) in adults;[10]
  • small superficial basal-cell carcinomas (sBCCs) in adults;[10]
  • clinically typical, non-hyperkeratotic, non-hypertrophic actinic keratoses (AKs) on the face or scalp in immunocompetent adults when size or number of lesions limit the efficacy and / or acceptability of cryotherapy and other topical treatment options are contraindicated or less appropriate.[10]

Imiquimod 3.75% cream is indicated for the topical treatment of clinically typical, non-hyperkeratotic, non-hypertrophic, visible or palpable actinic keratosis of the full face or balding scalp in immunocompetent adults when other topical treatment options are contraindicated or less appropriate.[11]

Side effects

Side effects include local inflammatory reactions, such as blisters, a burning sensation, skin redness, dry skin, itching, skin breakdown, skin crusting or scabbing, skin drainage, skin flaking or scaling, skin ulceration, sores, swelling, as well as systemic reactions, such as fever, "flu-like" symptoms, headache, and tiredness.[9][12]

People who have had an

organ transplant and are taking immune-suppressing drugs should not use imiquimod.[9]

Mechanism of action

Imiquimod yields profound antitumoral activity by acting on several immunological levels synergistically.

Imiquimod exerts its effect by increasing levels of the

siRNA technology resulted in loss of any antiproliferative effect of imiquimod.[18]

History

Scientists at 3M's pharmaceutical division discovered imiquimod as part of a program to discover inhibitors of

In 2006, 3M sold its pharmaceutical business in the Americas to Graceway Pharmaceuticals, its European pharmaceutical business to Meda AB, and its pharmaceutical business in other territories to two private equity firms.[22]

Graceway declared bankruptcy in 2011, after the expiration of the patents on imiquimod, and its assets, including the rights to imiquimod branding and approvals in the Americas, were purchased by Medicis Pharmaceutical.[23]

Imiquimod 5% was approved for medical use in the European Union in September 1998.[10] Imiquimod 3.75% was approved for medical use in the European Union in August 2012.[11]

As of 2015, imiquimod is generic and is available worldwide under many brands.[1]

Research

One randomized double-blind Phase III clinical study found clearance of genital warts (an FDA-approved indication) improved from 9% with placebo to 24.9% with 3.75% imiquimod cream applied for up to eight weeks.[24]

Imiquimod has been tested for treatment of molluscum contagiosum. Two large randomized controlled trials, however, found no evidence of effectiveness of imiquimod in treating children with molluscum contagiosum, and concerning adverse effects were also noted.[25] These disprove earlier anecdotal claims and smaller, less reliable studies.[26][27][28][29]

Imiquimod has also been tested for treatment of

common warts (a 2012 Cochrane review found no randomized controlled trials),[32] plantar warts,[33] warts in people with suppressed immune systems,[34] flat warts on face and neck,[33] and warts under and around fingernails and toenails.[33] As of 2014, insufficient evidence exists to recommend treatment of warts (other than genital warts) with imiquimod, due to the small size of and lack of controls in existing studies.[35][33]

References

  1. ^ a b Drugs.com Drugs.com international listings for imiquimod Page accessed 14 June 2015
  2. ^ "Imiquimod topical Use During Pregnancy". Drugs.com. 29 May 2019. Retrieved 14 July 2020.
  3. FDA
    . Retrieved 22 October 2023.
  4. ^ "Imiquimod Topical". MedlinePlus. National Library of Medicine. Retrieved 2 June 2021.
  5. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  6. ^ "Imiquimod - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
  7. ^ "FDA Approval for Imiquimod". U.S. Food And Drug Administration. 1 January 2011. Archived from the original on 6 April 2015. Retrieved 19 October 2012. Imiquimod should be used for treatment of [superficial basal cell carcinoma] only when surgery is medically less appropriate
  8. ^ "Imiquimod Cream". Guide To Cancer Drugs. American Cancer Society. Archived from the original on 7 February 2015. Retrieved 28 April 2014.
  9. ^ a b c European Medicines Agency. First published 14 September 2009, updated 25 March 2015. EMA Summary of Product Characteristics Archived 25 September 2017 at the Wayback Machine
  10. ^ a b c d "Aldara EPAR". European Medicines Agency (EMA). 17 September 2018. Retrieved 14 July 2020. Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  11. ^ a b "Zyclara EPAR". European Medicines Agency (EMA). 17 September 2018. Retrieved 14 July 2020. Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  12. ^ PDR Health PDR: Aldara
  13. S2CID 36643157
    .
  14. .
  15. .
  16. .
  17. ^ .
  18. .
  19. ^ Centerwatch. Centerwatch:Aldara (imiquimod) Page accessed 14 June 2015
  20. ^ "NCI: FDA Approval for Imiquimod". National Cancer Institute. 3 July 2013. Archived from the original on 23 January 2018.
  21. ^ "Press release: 3M Reaches Agreements to Sell its Pharmaceuticals Business]". 3M. 9 November 2006. Archived from the original on 21 August 2019.
  22. ^ Johnson JA (29 November 2011). "Medicis buys Graceway Pharmaceuticals for $455M". The Phoenix Business Journal.
  23. ^ Clinical trial number NCT00735462 for "Phase 3 Study of Imiquimod Creams in the Treatment of External Genital Warts" at ClinicalTrials.gov
  24. ^ "Aldara (imiquimod) cream for topical use. Prescribing information". Archived from the original on 2 November 2013.
  25. ^ Molluscum Contagiosum~treatment at eMedicine
  26. PMID 15379366
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  32. ^ a b c d "Imiquimod for non-genital cutaneous warts". www.dpic.org.
  33. S2CID 42369353
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  34. .

External links