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Nano-pulse stimulation reduces nongenital wart size

CHICAGO — Nano-pulse stimulation was associated with a reduction in cutaneous, nongenital wart size, according to data from a multicenter study presented at the American Society for Dermatologic Surgery annual meeting.

“[Nano-pulse stimulation] technology is the use of nontheramal energy that’s imparted using a high amplitude pulse between a row of needles, which affects the cellular structures in between in that field. In this case, it disrupts cellular membranes, but the lipid bilayer membranes is primarily the organelles, which leads to regulated cell death,” Girish Munavalli, MD, MHS, FACMS, medical director and founder of Dermatology, Laser and Vein Specialists of the Carolinas, said during his presentation.

According to Munavalli, Nano-Pulse Stimulation (NPS) Technology (Pulse Biosciences) is currently being used for benign lesions in clinical trials. Based on its unique immune-stimulated technologies, Munavalli and E. Victor Ross, MD, dermatologist at Scripps Clinic Carmel Valley, assessed its use in warts. In an initial study, Munavalli and Ross demonstrated, in a small cohort, 61% efficacy of treatment, with complete wart coverage at higher settings compared with other benign lesions. Based on this, the researchers embarked on a larger study.

The goal was to enroll 60 adults at five sites; to-date, 33 patients with 112 warts have been treated. Forty-five percent of warts were on feet and 34% were on hands and fingers.

In these early results, 66 warts were included, and 65% had failed previous treatment modalities. NPS was administered up to four times, according to investigator discretion, and was followed by three to five follow-up evaluations at days 7, 30, 60, 90 and 120.

Thirty-six percent of treated warts cleared within 30 days of a single NPS session, according to Munavalli, and the majority of warts saw a reduction of at least 50%. The highest clearance was seen for hand warts at 58%.

The researchers reported negligible hyperpigmentation (1.5%) at high settings, and no reports of hypopigmentation at this time. Additionally, results are pending for 33 of 66 warts that were treated a second time.

“One phenomenon we’re seeing is a bystander effect, in the sense that one lesion is treated and surrounding lesions in the adjacent area or in distant areas will also resolve, and that’s a very interesting property of this technology,” Munavalli said. – by Stacey L. Adams

Reference:

Ross EV, et al. First clinical use of non-thermal nano-pulse stimulation technology for treating cutaneous, non-genital warts. Presented at: American Society for Dermatologic Surgery Annual Meeting; Oct. 24-27, 2019; Chicago.

Disclosures: Munavalli and Ross report serving on the scientific advisory board for Pulse Biosciences.