A study published in Annals of Internal Medicine reports
that early treatment with Famvir (famciclovir) significantly shortens
the duration of postherpetic neuralgia in patients with herpes
Stephen K. Tyring, MD, PhD, principal investigator of the Collaborative
Famciclovir Herpes Zoster Study Group, reports that Famvir is
an effective and well-tolerated therapy for acute herpes zoster
that decreases the duration of postherpetic neuralgia, "by
far the most common complication of herpes zoster and one of the
most intractable pain disorders."
"Postherpetic neuralgia is clearly the most distressing component
of the disease process for both the patient and the physician,"
says Dr. Tyring, Professor of Dermatology, Microbiology/Immunology
and Internal Medicine at the University of Texas Medical Branch
at Galveston. "These findings suggest that early intervention
with famciclovir offers significant benefit to the shingles patient
by hastening healing of the rash and shortening the duration of
Up to 60% of patients over age 60 with shingles may suffer from
postherpetic neuralgia, with the incidence and severity increasing
with age. The pain of postherpetic neuralgia can last for months
or even years after the blisters disappear.
This placebo-controlled, double-blind study involved 419 otherwise
healthy patients with acute, uncomplicated herpes zoster who presented
within 72 hours of rash onset. Study patients, who averaged 50
years of age, were randomized to receive Famvir (500mg ot 750mg)
or placebo three time daily for 7 days.
Famvir was well tolerated, with a safety profile similar to placebo.
The most common side effects with placebo and Famvir respectively,
include diarrhea (4.8% vs 7.7%), nausea (11.6% vs 12.5%) and headache
(17.8% vs 22.7%).
Famvir (500 mg and 750 mg) given three times daily significantly
reduced the time to healing of zoster lesions (ie, time to full
crusting, loss of vesicles, loss of ulcers and loss of crusts)
Most importantly, the duration of postherpetic neuralgia, defined
as pain following healing, was significantly shorter in patients
who received Famvir (500 mg or 750 mg) rather than placebo, and
resulted in a 2 month reduction in median duration of postherpetic
Famciclovir is also being tested in clinical studies for the suppression
of recurrent genital herpes and asymptomatic viral shedding, and
for the treatment of herpes labialis, herpes virus infections
in immunocompromised patients and hepatitis B.
The raearch was supported in part by a grant from the National
Institute of Health and by a grant from Smithline Beecham Pharmaceuticals.