Oral famciclovir for suppression of recurrent genital herpes simplex virus infection in women. A multicenter, double-blind, placebo-controlled trial. Collaborative Famciclovir Genital Herpes Research Group

Mertz, Grégory; Loveless, Mark O.; Levin, M J; Kraus, Stephen J.; Fowler, Sandra L.; Goade, Diane; Sk, Tyring

doi:10.1001/archinte.157.3.343

Cited by 63 publications

(51 citation statements)

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“…Oncedaily dosing schedules were less effective or provided no significant benefit. 65 A larger study evaluating 250 mg of famciclovir twice a day demonstrated that 70% of those receiving the drug were recurrence free for 1 year, compared with only 20% of patients in the placebo group. 82 Various regimens of the drug (125 mg 3 times a day, 250 mg 3 times a day, and 250 mg twice a day) significantly increase time to first recurrence and percentage of patients remaining recurrence free for 1 year.…”

Section: Cst In Genital Herpes Simplexmentioning

confidence: 99%

The Treatment of Herpes Simplex Infections<subtitle>An Evidence-Based Review</subtitle>

Cernik¹

2008

Arch Intern Med

164

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enital and labial herpes simplex virus infections are frequently encountered by primary care physicians in the United States. Whereas the diagnosis of this condition is often straightforward, choosing an appropriate drug (eg, acyclovir, valacyclovir hydrochloride, or famciclovir) and dosing regimen can be confusing in view of (1) competing clinical approaches to therapy; (2) evolving dosing schedules based on new research;(3) approved regimens of the Food and Drug Administration that may not match recommendations of the Centers for Disease Control and Prevention or of other experts; and (4) dissimilar regimens for oral and genital infections. The physician must first choose an approach to treatment (ie, intermittent episodic therapy, intermittent suppressive therapy, or chronic suppressive therapy) based on defined clinical characteristics and patient preference. Then, an evidence-based dosing regimen must be selected. In this review, data from all sources are tabulated to provide a handy clinical reference.

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Section: Cst In Genital Herpes Simplexmentioning

confidence: 99%

The Treatment of Herpes Simplex Infections<subtitle>An Evidence-Based Review</subtitle>

Cernik¹

2008

Arch Intern Med

164

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“…While effective, this approach requires chronic daily dosing to maintain inhibition of the virus, demands good compliance, and is expensive (14,15,17,18,19). There is no posttreatment efficacy; discontinuation of suppressive treatment results in reversion to the pretreatment recurrence rate (6,23).…”

mentioning

confidence: 99%

Imiquimod 5-Percent Cream Does Not Alter the Natural History of Recurrent Herpes Genitalis: a Phase II, Randomized, Double-Blind, Placebo-Controlled Study

Schacker

Conant

Thoming

et al. 2002

Antimicrob Agents Chemother

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Present strategies for control of herpes genitalis recurrences require multiple daily doses of antiviral medication. Imiquimod, an immune response modifier, induces alpha interferon and interleukin-12; application in the presence of local herpes antigens during a recurrence may augment herpes simplex virus (HSV)-specific cell-mediated immunity. To test this theory, we performed a randomized, double-blind, placebocontrolled study of imiquimod 5% cream to assess safety and efficacy for decreasing recurrences. Patients with six or more recurrences of herpes genitalis per year applied study cream (imiquimod or placebo) to lesions one, two, or three times per week for 3 weeks for each recurrence during a 16-week treatment period. This was followed by a 16-week observation period. Of 124 patients randomized to the study, 103 completed the treatment period and 93 completed the observation period. The median times to first genital herpes recurrence were 53 days for those receiving placebo (n ‫؍‬ 30) and 54, 60, and 64 days for those receiving imiquimod one time per week (n ‫؍‬ 34), two times per week (n ‫؍‬ 32), and three times per week (n ‫؍‬ 28), respectively. The median annualized recurrence rates during the treatment period were 3.8, 4.9, 3.2, and 3.1, respectively. There were no statistically significant differences in the time to first recurrence or in the annualized recurrence rate between the imiquimod and placebo groups in either the treatment or the observation period. A trend in increased rates of local adverse events at the application site and a delay in lesion healing with more frequent dosing suggested a pharmacologic effect. Although clinical efficacy has been observed for imiquimod in other conditions in which a TH1-type immune response may be beneficial, including other viral infections such as those caused by human papillomavirus, no apparent effect on the short-term natural history of herpes genitalis recurrences was observed.

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“…Acyclovir (ACV), valacyclovir and famciclovir have a similar mechanism of antiviral action against HSV Mertz et al, 1997;Sacks, 2004). Acyclovir is a purine nucleoside analogue with inhibitory activity against HSV-1, HSV-2 and VZV.…”

Section: Acyclovir and Analogsmentioning

confidence: 99%

Point Mutations and Antiviral Drug Resistance

Arellano‐Galindo¹,

Barrón²,

Vargas-Infante³

et al. 2012

Point Mutation

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Oral famciclovir for suppression of recurrent genital herpes simplex virus infection in women. A multicenter, double-blind, placebo-controlled trial. Collaborative Famciclovir Genital Herpes Research Group

Abstract: Oral famciclovir, 250 mg, given twice daily for 4 months is an effective, well-tolerated treatment for the suppression of genital herpes in women with frequent recurrences, but single daily doses produced less complete suppression of genital herpes.

Cited by 63 publications

References 0 publications

The Treatment of Herpes Simplex Infections<subtitle>An Evidence-Based Review</subtitle>

The Treatment of Herpes Simplex Infections<subtitle>An Evidence-Based Review</subtitle>

Imiquimod 5-Percent Cream Does Not Alter the Natural History of Recurrent Herpes Genitalis: a Phase II, Randomized, Double-Blind, Placebo-Controlled Study

Point Mutations and Antiviral Drug Resistance

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