Valaciclovir versus aciclovir in patient initiated treatment of recurrent genital herpes: a randomised, double blind clinical trial. International Valaciclovir HSV Study Group.

Bodsworth, Neil J.; Crooks, R. J.; Borelli, Sueli Donizete; Vejlsgaard, Gunhild L.; Paavonen, Jorma; Worm, Anne‐Marie; Uexkull, N; Esmann, Jørgen; Strand, Anders; Ingamells, A.J.; Gibb, Adam

doi:10.1136/sti.73.2.110

Cited by 44 publications

(23 citation statements)

References 19 publications

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“…In addition, acyclovir significantly increased the proportion of episodes that involved aborted lesions. The magnitude of the reduction-from a median duration of lesions of 6 days to 4 days-is similar to that reported in the recent studies of acyclovir, valacyclovir, and famciclovir [4][5][6]. Our study showed that high-dose episodic therapy with acyclovir for recurrent genital herpes is effective even if it is administered for only 2 days.…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies have shown that higher dosages of acyclovir (800 mg po 5 times a day) do not result in shorter durations of the primary episode than does a standard dosage of acyclovir [13]. Similarly, treatment with valacyclovir has not demonstrated improvement in any efficacy measurements for episodic or suppressive therapy of genital herpes compared with acyclovir [4,5,14]. A higher blood level of acyclovir, which can be achieved with higher doses of acyclovir or by administering the prodrug, may be an important contributor to the antiviral effect early during the treatment.…”

Section: Discussionmentioning

confidence: 92%

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Two‐Day Regimen of Acyclovir for Treatment of Recurrent Genital Herpes Simplex Virus Type 2 Infection

et al. 2002

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The standard course of antiviral therapy for recurrent genital herpes requires administration of multiple doses of medication for 5 days. To assess the efficacy of a shorter course of antiviral therapy, patients with recurrent genital herpes simplex virus type 2 (HSV-2) infection were enrolled in a randomized, double-blind, placebo-controlled study of acyclovir (800 mg given by mouth 3 times per day [t.i.d.]) for 2 days. Of 131 people enrolled in the study, 84 (51 women and 33 men) were observed for >/=1 recurrence and 65 were observed for 2 recurrences, for which the patient was administered the same study drug (acyclovir or placebo). Acyclovir therapy (800 mg given by mouth t.i.d. for 2 days) significantly reduced the duration of lesions (median for acyclovir versus placebo, 4 days versus 6 days; P=.001), episode (4 days versus 6 days; P<.001), and viral shedding (25 hours versus 58.5 hours; P=.04), and it increased the proportion of aborted episodes (P=.029). A 2-day course of acyclovir is a convenient alternative for treatment of recurrent genital herpes.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 92%

Two‐Day Regimen of Acyclovir for Treatment of Recurrent Genital Herpes Simplex Virus Type 2 Infection

et al. 2002

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“…Famciclovir significantly reduced the time to healing of nonaborted and aborted lesions compared with placebo. The reduction in healing time for the nonaborted lesions is consistent with previous studies of longer regimens with aciclovir, valaciclovir, and famciclovir [8,9,[16][17][18].…”

Section: Discussionsupporting

confidence: 79%

Single-Day, Patient-Initiated Famciclovir Therapy for Recurrent Genital Herpes: A Randomized, Double-Blind, Placebo-Controlled Trial

Aoki¹,

Tyring²,

Díaz‐Mitoma³

et al. 2006

Clinical Infectious Diseases

103

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Background. Orally administered antiviral therapy for genital herpes improves the time to lesion healing and resolves symptoms during an outbreak. Although traditional therapy for a recurrent episode for healthy adults has consisted of twice-daily dosing for 5 days, recent studies have indicated that shorter courses of antiviral therapy are effective. This study was conducted to assess the efficacy and safety of a patient-initiated, single-day regimen of famciclovir therapy, compared with placebo, in immunocompetent adult patients with recurrent genital herpes.Methods. This multicenter, multinational, randomized, double-blind, parallel-group, placebo-controlled study compared single-day, patient-initiated oral famciclovir (1000 mg given twice daily) with placebo for the treatment of recurrent genital herpes. Patients were instructed to initiate therapy within 6 h after onset of prodromal symptoms or genital herpes lesions.Results. Famciclovir reduced ( ) the time to healing of nonaborted lesions (i.e., those that did not P ! .001 progress beyond the papule stage) (median time, 4.3 vs. 6.1 days) and all nonaborted and aborted lesions (median time, 3.5 vs. 5.0 days), compared with placebo. The proportion of patients with aborted lesions was larger in the famciclovir group than in the placebo group (23.3% vs. 12.7%;). Adverse events in the famciclovir group P p .003 were infrequent overall; most were of mild-to-moderate severity and were similar to adverse events in the placebo group.Conclusions. A single-day regimen of patient-initiated famciclovir treatment was well tolerated and safe, and the healing of recurrent genital herpes lesions occurred ∼2 days faster than with placebo. Moreover, single-day famciclovir treatment stopped the development or progression of lesions beyond the papule stage. This convenient single-day regimen has the potential for improving patient compliance and satisfaction with therapy.

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“…1). Past reports 30,31 have compared the blood levels of the oral VCV-treated (1000 mg, 3 times/day) and oral ACV-treated (800 mg, 5 times/day) groups and showed that the oral VCV-treated group had higher blood level (25.2 µM) than the ACV-treated group (7.1 µM). It was therefore suggested that oral VCV is more effective than oral ACV if the dosage is equally converted for both treatments.…”

Section: Discussionmentioning

confidence: 95%

Effects of Anti Herpetic Drugs on Mice with Herpetic Epithelial Keratitis After Reactivation of Herpes Simplex Virus Type 1

Itahashi

Higaki

Shimomura

2008

Seminars in Ophthalmology

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To compare the efficacies of valacyclovir (VCV) and acyclovir (ACV) on murine herpetic epithelial keratitis, mice inoculated with herpes simplex virus type 1(HSV-1) strain McKrae were divided into 6 treatment groups: oral VCV 50 mg/kg and 100 mg/kg, oral ACV 50 mg/kg, ACV eye ointment (EO), ACV eye drops (ED), and placebo. Keratitis scores showed that oral VCV 50 mg/kg, oral ACV, and ACV ED had equivalent efficacies, while oral VCV 100 mg/kg was as efficacious as ACV EO during acute infection. Each treatment group was further divided into the stimulated group with HSV-1 reactivation by immunosuppressant drugs and hyperthermia, and the non-stimulated group without reactivation. We assessed the virus titers in tissues by plaque assay and HSV DNA copy number in the trigeminal ganglia (TG) by real time polymerase chain reaction (PCR). Results showed that the virus titers in the tissues were lowered after reactivation, and the oral VCV group with reactivation had significantly reduced DNA copy number in the TG than the same treatment group without reactivation. In conclusion, oral VCV is as efficacious as ACV EO and significantly suppresses HSV-1 reactivation.

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Valaciclovir versus aciclovir in patient initiated treatment of recurrent genital herpes: a randomised, double blind clinical trial. International Valaciclovir HSV Study Group.

Cited by 44 publications

References 19 publications

Two‐Day Regimen of Acyclovir for Treatment of Recurrent Genital Herpes Simplex Virus Type 2 Infection

Two‐Day Regimen of Acyclovir for Treatment of Recurrent Genital Herpes Simplex Virus Type 2 Infection

Single-Day, Patient-Initiated Famciclovir Therapy for Recurrent Genital Herpes: A Randomized, Double-Blind, Placebo-Controlled Trial

Effects of Anti Herpetic Drugs on Mice with Herpetic Epithelial Keratitis After Reactivation of Herpes Simplex Virus Type 1

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