A randomized controlled trial of acyclovir versus netivudine for treatment of herpes zoster. International Zoster Study Group.

Abstract	Oral acyclovir has become the standard of care for treatment of acute herpes zoster. Netivudine is a novel antiviral with greater in-vitro activity against varicella zoster virus. It was compared with acyclovir in a randomized, double-blind, controlled trial in immunocompetent adults with herpes zoster. Patients with rash for less than 72 h were assigned to receive either acyclovir or netivudine, then assessed regularly for 6 months. No evidence for a dose response with netivudine was found, so intent-to-treat analyses of all 511 enrolled patients compared acyclovir with netivudine. The time to complete cessation of pain (P = 0.007) and to cessation of moderate to excruciating pain (P = 0.005) was accelerated in acyclovir recipients. Rash outcomes and adverse event profiles were similar for both treatments. This study has confirmed the efficacy of acyclovir in decreasing the duration and severity of pain following herpes zoster. Greater in-vitro activity of newer agents may not necessarily provide greater benefit in humans.
Authors	J Söltz-Szöts, S Tyring, P L Andersen, R F Lucht, M W McKendrick, J L Diaz Perez, S Shukla, A P Fiddian
Journal	The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 41 Issue 5 Pg. 549-56 (May 1998) ISSN: 0305-7453 [Print] England
PMID	9630408 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References	Antiviral Agents Arabinofuranosyluracil 5-propynylarabinofuranosyluracil Acyclovir
Topics	Acyclovir (administration & dosage, adverse effects, therapeutic use) Aged Antiviral Agents (administration & dosage, adverse effects, therapeutic use) Arabinofuranosyluracil (administration & dosage, adverse effects, analogs & derivatives, therapeutic use) Double-Blind Method Drug Administration Schedule Exanthema (drug therapy) Female Herpes Zoster (complications, drug therapy, physiopathology) Humans Male Middle Aged Pain (drug therapy) Prognosis

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