A Comparative Study to Evaluate the Efficacy and Safety of Acyclovir and Famciclovir in the Management of Herpes Zoster

Gopal, MG; Shannoma,; Kumar, B C Sharath; Ramesh, M; Nandini, AS; Manjunath, Namrata C.

doi:10.7860/jcdr/2013/7884.3670

Cited by 7 publications

(6 citation statements)

References 6 publications

(6 reference statements)

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“…In a recent study, an economic comparison between valacyclovir and valganciclovir was performed, suggesting that in the first year after renal transplantation, valganciclovir was more cost-effective than valacyclovir (255). On the other hand, famciclovir offers significant benefits, such as cost-effective therapy and accelerated rates of lesion resolution (256). For these reasons, famciclovir is now widely used to treat HSV or VZV infections.…”

Section: Acyclic Guanosine Analoguesmentioning

confidence: 99%

Approved Antiviral Drugs over the Past 50 Years

2016

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SUMMARYSince the first antiviral drug, idoxuridine, was approved in 1963, 90 antiviral drugs categorized into 13 functional groups have been formally approved for the treatment of the following 9 human infectious diseases: (i) HIV infections (protease inhibitors, integrase inhibitors, entry inhibitors, nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and acyclic nucleoside phosphonate analogues), (ii) hepatitis B virus (HBV) infections (lamivudine, interferons, nucleoside analogues, and acyclic nucleoside phosphonate analogues), (iii) hepatitis C virus (HCV) infections (ribavirin, interferons, NS3/4A protease inhibitors, NS5A inhibitors, and NS5B polymerase inhibitors), (iv) herpesvirus infections (5-substituted 2′-deoxyuridine analogues, entry inhibitors, nucleoside analogues, pyrophosphate analogues, and acyclic guanosine analogues), (v) influenza virus infections (ribavirin, matrix 2 protein inhibitors, RNA polymerase inhibitors, and neuraminidase inhibitors), (vi) human cytomegalovirus infections (acyclic guanosine analogues, acyclic nucleoside phosphonate analogues, pyrophosphate analogues, and oligonucleotides), (vii) varicella-zoster virus infections (acyclic guanosine analogues, nucleoside analogues, 5-substituted 2′-deoxyuridine analogues, and antibodies), (viii) respiratory syncytial virus infections (ribavirin and antibodies), and (ix) external anogenital warts caused by human papillomavirus infections (imiquimod, sinecatechins, and podofilox). Here, we present for the first time a comprehensive overview of antiviral drugs approved over the past 50 years, shedding light on the development of effective antiviral treatments against current and emerging infectious diseases worldwide.

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Section: Acyclic Guanosine Analoguesmentioning

confidence: 99%

Approved Antiviral Drugs over the Past 50 Years

2016

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“…Valaciclovir resolves pain significantly faster than aciclovir [31, 653–655], while famciclovir has comparable efficacy but fewer adverse effects, and may also be more cost-effective [656, 657]. Penciclovir is also effective at lower doses than aciclovir, with better safety [658].…”

Section: Management and Preventionmentioning

confidence: 99%

“…A meta-analysis including data from Taiwan [ 653 , 654 ] and China, found valaciclovir and famciclovir superior to aciclovir in reducing HZ-associated pain, with comparable safety [ 652 ]. Valaciclovir resolves pain significantly faster than aciclovir [ 31 , 653 – 655 ], while famciclovir has comparable efficacy but fewer adverse effects, and may also be more cost-effective [ 656 , 657 ]. Penciclovir is also effective at lower doses than aciclovir, with better safety [ 658 ].…”

Section: Management and Preventionmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

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BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

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“…There are three classes of drugs approved for treatment of HSV infections, and all of which target viral DNA replication: acyclic guanosine analogues, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 acyclic nucleotide analogues, 33 , 34 , 35 and pyrophosphate analogues 36 – 37 ( Table 1 ). Typical drugs from these three categories include valacyclovir (VCV), cidofovir, and foscarnet.…”

Section: Herpes Simplex Virus and Drug Resistancementioning

confidence: 99%

New strategies against drug resistance to herpes simplex virus

et al. 2016

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Herpes simplex virus (HSV), a member of the Herpesviridae family, is a significant human pathogen that results in mucocutaneous lesions in the oral cavity or genital infections. Acyclovir (ACV) and related nucleoside analogues can successfully treat HSV infections, but the emergence of drug resistance to ACV has created a barrier for the treatment of HSV infections, especially in immunocompromised patients. There is an urgent need to explore new and effective tactics to circumvent drug resistance to HSV. This review summarises the current strategies in the development of new targets (the DNA helicase/primase (H/P) complex), new types of molecules (nature products) and new antiviral mechanisms (lethal mutagenesis of Janus-type nucleosides) to fight the drug resistance of HSV.

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A Comparative Study to Evaluate the Efficacy and Safety of Acyclovir and Famciclovir in the Management of Herpes Zoster

Cited by 7 publications

References 6 publications

Approved Antiviral Drugs over the Past 50 Years

Approved Antiviral Drugs over the Past 50 Years

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

New strategies against drug resistance to herpes simplex virus

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