Docosanol: new drug. Herpes labialis: barely more effective than an excipient.
(1) Herpes is a contagious, recurrent viral infection of the skin and mucous membranes. In immunocompetent patients the recurrences can be troublesome but they heal spontaneously. Management is mainly based on lifestyle measures. Local application of an antiviral drug such as aciclovir has modest effects. It reduces healing time by about 2 days provided treatment is started as soon as the first symptoms appear; (2) Docosanol, a fatty alcohol, was recently authorized in France for treatment of episodes of herpes labialis; (3) A trial in 474 patients showed no tangible difference between docosanol and 5% aciclovir in reducing healing time; (4) Clinical evaluation also includes two trials versus an excipient (polyethylene glycol) including 370 and 373 patients. The median healing time was reduced by less than a day; (5) In these trials, the adverse effects of docosanol were similar to those of the excipients. In particular, docosanol cream contains excipients that can provoke allergic reactions; (6) In practice, docosanol cream is barely or no more effective than an excipient in treating acute episodes of herpes labialis. Lifestyle measures are still the cornerstone of herpes management.
D000212:Acyclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D017277:Drug Approval; D005079:Excipients / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005233:Fatty Alcohols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005602:France; D006560:Herpes Labialis / Q000188:drug therapy*; D006801:Humans; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013229:Stearic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000998:Antiviral Agents; D005079:Excipients; D005233:Fatty Alcohols; D013229:Stearic Acids; D011092:Polyethylene Glycols; C529236:docosanol; D000212:Acyclovir