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Efficacy and safety of imiquimod 5% cream for basal cell carcinoma: a meta-analysis of randomized controlled trial

Abstract Background: We conducted this meta-analysis to compare the efficacy and safety of imiquimod with other treatments in patients with basal cell carcinoma (BCC). Methods: A comprehensive literature search was performed in the database of PubMed, Embase, and Web of Science, focusing on studies that evaluated the efficacy and safety profile of BCC patients who were treated with imiquimod. The main outcome measures included histological/composite clearance rate, success rate, complete response rate, tumor free survival, and adverse events. Results were expressed as risk ratio (RR) with 95% confidence intervals (CIs). Pooled estimates were calculated using a fixed-effects or random-effects model according to the heterogeneity among studies. Results: A total of 13 studies involving 4256 patients were included in this meta-analysis. Imiquimod was associated with significantly higher histological clearance rate and composite clearance rate. Moreover, imiquimod also significantly increased complete response rate but had no effect in the success rate and probability of tumor free survival, as compared with other treatments. There were more patients with imiquimod developed adverse events than those with other treatments. Conclusion: The present meta-analysis indicated the effects of imiquimod in improving the histological/composite clearance rates as compared with other treatments.