Antiviral therapy for herpes zoster: randomized, controlled clinical trial of valacyclovir and famciclovir therapy in immunocompetent patients 50 years and older.

Abstract

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).

• Authors: S K Tyring, K R Beutner, B A Tucker, W C Anderson, R J Crooks
• Journal: Archives of family medicine (Arch Fam Med) 2000 Sep-Oct Vol. 9 Issue 9 Pg. 863-9 ISSN: 1063-3987 [Print] United States
• PMID: 11031393 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• 2-Aminopurine
• Valine
• Valacyclovir
• Famciclovir
• Acyclovir

Topics

• 2-Aminopurine (analogs & derivatives, economics, therapeutic use)
• Acyclovir (analogs & derivatives, economics, therapeutic use)
• Aged
• Antiviral Agents (economics, therapeutic use)
• Cost-Benefit Analysis
• Double-Blind Method
• Famciclovir
• Female
• Herpes Zoster (drug therapy)
• Humans
• Male
• Middle Aged
• Neuralgia (etiology, prevention & control)
• Pain (etiology, prevention & control)
• Proportional Hazards Models
• Time Factors
• Valacyclovir
• Valine (analogs & derivatives, economics, therapeutic use)