Single-dose therapy for herpes somewhat effective when administered early

Block SL. Pediatr Infect Dis J. 2010;doi:10.1097/INF.0b013e3182067cee.

Issue: March 2011

A single dose of famciclovir appeared to be “moderately efficacious” in adolescents when administered within one day of herpes onset. Therefore, this therapy may be an option for adolescents, according to new study findings.

Currently, valacyclovir is approved for treatment in adolescents and adults in a two-dose regimen of 2 g per dose given 12 hours apart, and famciclovir taken as single-dose therapy is approved in adults only.

Stan L. Block, MD, professor of clinical pediatrics at the University of Kentucky College of Medicine, and colleagues said the pharmacokinetics and safety profile of famciclovir (Famvir, Novartis) appear similar to those seen in adults. A Kaplan-Meier analysis revealed a median time to healing of 5.9 days for nonaborted lesions and 5.1 days for the eight patients with aborted lesions.

The researchers said not to draw any conclusions based on the healing time because the study did not include a control group, and the therapy was clinic-initiated at a median time of 21 hours after herpes symptom onset.

“Thus, the optimal intervention time was probably missed in most of our patients,” Block and colleagues said. “Further studies comparing treated and untreated patients are needed.”

The researchers said their study has important clinical implications because regimen complexity, adverse events, pill burden, cost and “hectic adolescent lifestyles” contribute to low adherence with therapeutic regimens.

“Studies have shown that shorter duration and less frequent dosing improve adherence, with once-daily dosing being optimal,” the researchers wrote. “Thus, simplified dosing should contribute to improved therapy compliance, patient acceptability and treatment outcomes.”

Disclosure: The study was supported by Novartis.

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