The EVerT2 (Effective Verruca Treatments 2) Trial: a randomised controlled trial of needling versus nonsurgical debridement for the treatment of plantar verrucae

TY - JOUR

T1 - The EVerT2 (Effective Verruca Treatments 2) Trial

T2 - a randomised controlled trial of needling versus nonsurgical debridement for the treatment of plantar verrucae

AU - Hashmi, F

AU - Fairhurst, C

AU - Cockayne, S

AU - Cullen, M

AU - Bell, K

AU - Coleman, E

AU - Harrison-Blount, M

AU - Torgerson, D

N1 - This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - BACKGROUND: Verrucae are a common foot skin pathology which can in some cases persist for many years. Plantar verrucae can be unsightly and painful. There are a range of treatment options including needling.OBJECTIVES: The EVerT2 trial aimed to evaluate the clinical and cost effectiveness of the needling procedure for the treatment of plantar verrucae, relative to callus debridement.METHODS: This single centre randomised controlled trial recruited 60 participants (aged 18 years and over with a plantar verruca). Participants were randomised 1:1 to the intervention group (needling) or the control group (debridement of the overlying callus). The primary outcome was clearance of the index verruca at 12 weeks after randomisation. Secondary outcomes include recurrence of the verruca; clearance of all verrucae; number of verrucae; size of the index verruca; pain; and participant satisfaction at 12 and 24 weeks. A cost-effectiveness analysis was carried out from the NHS perspective over 12 weeks.RESULTS: Sixty eligible patients were randomised (needling group n=29, 48.3%; debridement group n=31, 51.7%) and 53 were included in the primary analysis (needling n=28, 96.6%; debridement n=25, 80.7%). Clearance of the index verruca occurred in 8 (15.1%) participants (needling n=4, 14.3%; debridement n=4, 16.0%, p=0.86). The needling intervention costs were on average £14.33 (95% CI 5.32 to 23.35) more per patient than debridement.CONCLUSIONS: There is no evidence that the needling technique is more clinically or cost effective than callus debridement. The results show a significant improvement in pain outcomes after needling compared to the debridement treatment alone. This article is protected by copyright. All rights reserved.

AB - BACKGROUND: Verrucae are a common foot skin pathology which can in some cases persist for many years. Plantar verrucae can be unsightly and painful. There are a range of treatment options including needling.OBJECTIVES: The EVerT2 trial aimed to evaluate the clinical and cost effectiveness of the needling procedure for the treatment of plantar verrucae, relative to callus debridement.METHODS: This single centre randomised controlled trial recruited 60 participants (aged 18 years and over with a plantar verruca). Participants were randomised 1:1 to the intervention group (needling) or the control group (debridement of the overlying callus). The primary outcome was clearance of the index verruca at 12 weeks after randomisation. Secondary outcomes include recurrence of the verruca; clearance of all verrucae; number of verrucae; size of the index verruca; pain; and participant satisfaction at 12 and 24 weeks. A cost-effectiveness analysis was carried out from the NHS perspective over 12 weeks.RESULTS: Sixty eligible patients were randomised (needling group n=29, 48.3%; debridement group n=31, 51.7%) and 53 were included in the primary analysis (needling n=28, 96.6%; debridement n=25, 80.7%). Clearance of the index verruca occurred in 8 (15.1%) participants (needling n=4, 14.3%; debridement n=4, 16.0%, p=0.86). The needling intervention costs were on average £14.33 (95% CI 5.32 to 23.35) more per patient than debridement.CONCLUSIONS: There is no evidence that the needling technique is more clinically or cost effective than callus debridement. The results show a significant improvement in pain outcomes after needling compared to the debridement treatment alone. This article is protected by copyright. All rights reserved.

KW - Journal Article

KW - Warts/economics

KW - Humans

KW - Middle Aged

KW - Debridement/economics

KW - Male

KW - Treatment Outcome

KW - Foot Dermatoses/economics

KW - Patient Satisfaction

KW - Young Adult

KW - Musculoskeletal Pain/etiology

KW - Cost-Benefit Analysis

KW - Adult

KW - Female

KW - Needles

KW - Aged

UR - http://www.scopus.com/inward/record.url?scp=85032836203&partnerID=8YFLogxK

U2 - 10.1111/bjd.15751

DO - 10.1111/bjd.15751

M3 - Article

C2 - 28653324

SN - 0007-0963

VL - 177

SP - 1285

EP - 1292

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 5

ER -