 |
|
Antiviral Therapy for Herpes Zoster
Randomized, Controlled Clinical Trial of Valacyclovir and Famciclovir Therapy in Immunocompetent Patients 50 Years and Older
Stephen K. Tyring, MD, PhD;
Karl R. Beutner, MD, PhD;
Bruce A. Tucker, MD;
Walter C. Anderson, MD;
R. Jane Crooks, PhD
Arch Fam Med. 2000;9:863-869.
Objective To compare the efficacy and safety of valacyclovir hydrochloride and famciclovir for the treatment of herpes zoster.
Design A double-blind, randomized, controlled, multicenter clinical trial in which patients received 7 days of treatment and were followed up for 24 weeks.
Settings Patients reported directly to specialist centers or were referred from primary care centers.
Patients There were 597 otherwise healthy immunocompetent outpatients, aged 50 years and older, who presented within 72 hours of onset of zoster rash.
Interventions Treatment with valacyclovir hydrochloride (1 g 3 times daily) or famciclovir (500 mg 3 times daily) for 7 days.
Main Outcome Measures Resolution of zoster-associated pain and postherpetic neuralgia, rash healing, and treatment safety.
Results Intent-to-treat analysis did not detect statistically significant differences for valacyclovir vs famciclovir on resolution of zoster-associated pain (hazard ratio, 1.02; 95% confidence interval, 0.84-1.23; P = .84). Furthermore, no differences were evident between treatments on rash healing rates and on a range of analyses of postherpetic neuralgia. Safety profiles for valacyclovir and famciclovir were similar, with headache and nausea being the more common adverse events.
Conclusions Valacyclovir treatment is comparable to famciclovir treatment in speeding the resolution of zoster-associated pain and postherpetic neuralgia. Current wholesale prices indicate that valacyclovir is the more cost-effective treatment for herpes zoster ($83.90 vs $140.70 per course).
From the Department of Dermatology, University of Texas Medical Branch at Galveston (Dr Tyring); Solano Dermatology Associates, Vallejo, Calif (Dr Beutner); Simon-Williamson Clinic PC, Birmingham, Ala (Dr Tucker) and Glaxo Wellcome Research and Development, Greenford, England (Dr Crooks). Dr Anderson is in private practice in New Braunfels, Tex. Drs Tyring and Beutner are consultants to and members of a speakers' program involving Glaxo Wellcome Inc, Research Triangle Park, NC.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
A 70-Year-Old Woman With Shingles: Review of Herpes Zoster
Whitley
JAMA 2009;302:73-80.
ABSTRACT
| FULL TEXT
Management Strategies for Herpes Zoster and Postherpetic Neuralgia
Galluzzi
JAOA: Journal of the American Osteopathic Association 2007;107:S8-S13.
ABSTRACT
| FULL TEXT
Herpes zoster and the prevention of postherpetic neuralgia: Beyond antiviral therapy
Tenser and Dworkin
Neurology 2005;65:349-350.
FULL TEXT
VZV vasculopathy and postherpetic neuralgia: Progress and perspective on antiviral therapy
Gilden et al.
Neurology 2005;64:21-25.
ABSTRACT
| FULL TEXT
80-Year-Old Man With Fever and Ear Pain
Lim and Takahashi
Mayo Clin Proc. 2004;79:1055-1058.
Risk factors for postherpetic neuralgia in patients with herpes zoster
Jung et al.
Neurology 2004;62:1545-1551.
ABSTRACT
| FULL TEXT
Herpes Zoster
Gnann and Whitley
NEJM 2002;347:340-346.
FULL TEXT
Valacyclovir or Famciclovir for Herpes Zoster?
Journal Watch Dermatology 2000;2000:7-7.
FULL TEXT
|
