Ganciclovir Ophthalmic Gel (Virgan; 0.15%) in the Treatment of Herpes Simplex Keratitis

Colin, Joseph; Hoh, H B; Easty, D L; Herbort, Carl P.; Resnikoff, Serge; Rigal, D; Romdane, K

doi:10.1097/00003226-199707000-00004

Cited by 66 publications

(108 citation statements)

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“…Additionally, despite the high viscosity (50,000 millipascal seconds) of the gel, blurring occurs less often with ganciclovir 0.15% gel than with acyclovir ointment, 28 making it a more tolerable option for patients. Herpes simplex virus (HSV) keratitis is a common cause of ocular and visual morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned above, four international trials have compared the safety and efficacy of ganciclovir 0.15% gel with acyclovir 3% in patients with HSK: three phase IIb trials conducted in Africa (study 1), 28,29 Europe (study 2), and Pakistan (study 3); and a phase III trial that stratified patients by dendritic or geographic ulcers (study 4) carried out in four European and African centers. The trials employed similar multicenter randomized designs, inclusion and exclusion criteria, dosing regimens, and end-points (study 3 was conducted at different sites within a single center).…”

Section: Clinical Trial Datamentioning

confidence: 99%

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Ganciclovir Gel—A New Topical Treatment for Herpetic Keratitis

Foster¹

2012

US Ophthalmic Review

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Trial Datamentioning

confidence: 99%

Ganciclovir Gel—A New Topical Treatment for Herpetic Keratitis

Foster¹

2012

US Ophthalmic Review

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“…Ensaios clínicos demonstraram bons resultados comparados com o tratamento padrão com aciclovir. O ganciclovir mostrou ser um antiviral tópico seguro e eficaz, com menos toxicidade e posologia mais conveniente (15,(21)(22)(23) . No entanto não existem estudos registrados no ClinicalTrials.gov em relação ao uso do ganciclovir em ceratoconjuntivite adenoviral.…”

Section: Discussionunclassified

Uso de ganciclovir 0,15% gel para tratamento de ceratoconjuntivite adenoviral

Yabiku¹,

Yabiku²,

Bottós³

et al. 2011

Arq. Bras. Oftalmol.

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Comitê de Ética em Pesquisa da UNIFESP/EPM -CEP 2042/08 RESUMOObjetivos: Determinar a efetividade e a toxicidade do ganciclovir 0,15% gel no tratamento de ceratoconjuntivites adenovirais e na prevenção de complicações tais como infiltrados corneanos, membranas ou pseudomembranas conjuntivais. Métodos: Ensaio clínico duplo-cego, intervencionista, randomizado. Os 33 pacientes com diagnóstico clínico de ceratoconjuntivite adenoviral com início dos sintomas há menos de cinco dias foram randomizados em dois grupos: Grupo 1 (tratamento) com 19 pacientes que usaram ganciclovir e Grupo 2 (controle) com 14 pacientes que usaram lágrima artificial sem conservante. Todos pacientes responderam a um questionário de sinais e sintomas e foram submetidos a um exame oftalmológico. No 6º dia de tratamento responderam ao mesmo questionário por telefone e no 10º dia foram reavaliados pelo mesmo examinador e responderam novamente ao questioná-rio. Os sinais e sintomas foram comparados. Para análise estatística foi utilizado os testes T de Student, Mann-Whitney e Wilcoxon, com significância estatística p<0,05. Resultados: Tendência de melhor resposta no grupo tratamento em relação à percepção pelos pacientes, além da melhora mais rápida desse grupo em relação ao grupo controle (p=0,26). Houve menor transmissão para o olho adelfo (p=0,86) e para pessoas do convívio (p=0,16) no grupo tratamento. Comparando os dois grupos não houve diferença estatística em relação aos sintomas e sinais da conjuntivite. Comparando isoladamente cada grupo entre o pré-tratamento e no decorrer do tratamento, observou-se melhora estatisticamente significativa da dor, prurido e fotofobia apenas no grupo tratamento. Ganciclovir não mostrou toxicidade e teve maior tolerância pelos pacientes. Não houve diferença significativa no aparecimento de complicações da conjuntivite entre os dois grupos. Conclusões: O estudo evidenciou uma tendência à melhora mais rápida dos sinais e sintomas dos pacientes tratados com ganciclovir em relação ao grupo controle, porém não estatisticamente significante. Esses resultados precisam ser confirmados por estudos adicionais, com maior número de pacientes e um seguimento mais extenso. Clinical Trails.gov: NCT01349452

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“…10,11 Ganciclovir is clinically effective and approved against herpesvirus infections when applied topically onto the eye. 12 Its mechanism of action involves inhibiting viral DNA replication through direct incorporation into viral DNA following its phosphorylation by viral thymidine kinase. This results in eventual termination of viral DNA elongation.…”

Section: Discussionmentioning

confidence: 99%

“…This results in eventual termination of viral DNA elongation. 12,13 It also makes the drug specific for infected cells and thus less toxic to non-affected cells.…”

Section: Discussionmentioning

confidence: 99%

Ganciclovir in the Treatment of Ophthalmic Viral Infections – Case Reports

Affeldt¹,

Gadaria-Rathod²,

Fernandez³

et al. 2012

US Ophthalmic Review

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Eye infections are common and represent a major healthcare burden.Herpes simplex virus type 1 (HSV-1) and, less commonly, HSV type 2 (HSV-2) have been responsible for ocular infections in approximately 400,000 Americans. Moreover, nearly 50,000 new and recurring cases are diagnosed annually in the US with a quarter of cases being the more serious stromal keratitis. 1 HSV is involved in the pathogenesis of several ocular disorders and may lead to numerous diseases including blepharitis, vesicular dermatitis of the eyelids, conjunctivits, keratitis, trabeculitis, anterior uveitis, acute retinal necrosis syndrome, retinitis and optic neuritis. 2 Adenovirus, however, is the most likely cause of the majority of eye infections. Adenoviral conjunctivitis is the most frequent cause of red eye and can lead to significant morbidity in patients. Although very common, it remains a challenge for ophthalmologists to both diagnose and treat, mainly because of its non-specific presentation and the numerous conditions that can cause pink eye. Aside from the difficulties in diagnosis and treatment of patients, contagiousness and easy transmission to family members is part of the challenge. At present, clinicians generally only offer supportive measures to treat these patients.Ganciclovir is an antiviral agent that is selectively active against viral DNA. This prodrug is a synthetic nucleoside analog of 2'-deoxyguanosine 9-(1,3-dihydroxy-2-propoxymethyl) guanine that is phosphorylated by the virus-encoded thymidine kinase. 2 Ganciclovir triphosphate then competitively inhibits incorporation of the endogenous nucleotide by the viral DNA polymerase. This results in replication arrest and damage to infected cells. and transmissibility. They found a trend to faster improvement and less transmissibility to the other eye and people living with affected patients in the treatment group, however these data were not statistically significant. AbstractAdenovirus is likely the most common cause of eye infections but remains a challenge for ophthalmologists to diagnose as well as treat.While ganciclovir gel is approved for the topical treatment of eye infections arising due to herpes simplex virus, it is not licensed for use against adenoviral conjunctivitis. This antiviral agent selectively targets infected cells and disrupts viral DNA replication. A small study and previous anecdotal reports had illustrated the potential of ganciclovir in improving symptoms and transmissibility of adenoviral eye infections. The present article describes a series of case studies where ganciclovir was used off label in the management of the morbidity caused by adenovirus. The observations are promising and suggest that ganciclovir can be used successfully in this patient population.However, large-scale randomised trials are needed to confirm these findings. KeywordsGanciclovir gel, adenoviral conjunctivitis, herpes simplex virus, off-label use, trifluridine toxicity, case studies Ophthalmic Viral Infections DOI: 10.17925/USOR.2012.05.02.100 Despite the enco...

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Ganciclovir Ophthalmic Gel (Virgan; 0.15%) in the Treatment of Herpes Simplex Keratitis

Cited by 66 publications

References 0 publications

Ganciclovir Gel—A New Topical Treatment for Herpetic Keratitis

Ganciclovir Gel—A New Topical Treatment for Herpetic Keratitis

Uso de ganciclovir 0,15% gel para tratamento de ceratoconjuntivite adenoviral

Ganciclovir in the Treatment of Ophthalmic Viral Infections – Case Reports

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