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Double-blind, randomized, placebo-controlled study of topical 5% acyclovir-1% hydrocortisone cream (ME-609) for treatment of UV radiation-induced herpes labialis.

Abstract
Immunopathology is recognized as an important component of infectious disease manifestations, and corticosteroids have been used as an adjunct to antimicrobial therapy for a variety of conditions. Antiviral therapy of herpes labialis has been shown to result in only a small reduction in the time to healing and the duration of pain. To determine if topical application of a combination product containing 5% acyclovir and 1% hydrocortisone (ME-609) could provide benefit to herpes labialis patients, 380 immunocompetent adults with a history of herpes labialis were exposed to experimental UV radiation (UVR) to induce a recurrence. On day 2, just before the appearance of the majority of lesions ("delayed" lesions), subjects were randomized to receive active medication or vehicle control six times per day for 5 days. Overall, 120 of 380 patients developed delayed classical lesions, of whom 50 of 190 (26%) had been treated with ME-609 and 70 of 190 (37%) had received placebo (a reduction of 29% [P = 0.02]). Healing time, measured as the time to normal skin, was reduced by treatment with ME-609 (9.0 days for treated patients versus 10.1 days for the controls [P = 0.04]). There was a trend toward a reduction in the maximum lesion size in the ME-609 recipients compared to that in the controls (43 versus 60 mm(2), respectively [P = 0.07]). The treatment had no effect on lesion pain, but ME-609 treatment reduced the number of patients with moderate or severe tenderness. Compared to treatment with a placebo, treatment with the combination antiviral-immunomodulatory cream provided benefit to patients with experimental UVR-induced herpes labialis, reducing classical lesion incidence, healing time, lesion size, and lesion tenderness. ME-609 is a novel product that merits further evaluation as a treatment for cold sores.
AuthorsT G Evans, D I Bernstein, G W Raborn, J Harmenberg, J Kowalski, S L Spruance
JournalAntimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 46 Issue 6 Pg. 1870-4 (Jun 2002) ISSN: 0066-4804 [Print] United States
PMID12019102 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Drug Combinations
  • Ointments
  • Hydrocortisone
  • Acyclovir
Topics
  • Acyclovir (administration & dosage, therapeutic use)
  • Administration, Topical
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents (administration & dosage, therapeutic use)
  • Antiviral Agents (administration & dosage, therapeutic use)
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Herpes Labialis (drug therapy, virology)
  • Humans
  • Hydrocortisone (administration & dosage, therapeutic use)
  • Male
  • Middle Aged
  • Ointments
  • Secondary Prevention
  • Ultraviolet Rays

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