Comparison between famciclovir and valacyclovir for acute pain in adult Japanese immunocompetent patients with herpes zoster.
Famciclovir is a guanine analog antiviral drug used commonly for herpes zoster. Efficacy of famciclovir treatment has been reported to be comparable to valacyclovir treatment. Both of these medications reduce the time to complete cessation of zoster-associated pain including post-herpetic neuralgia, as compared to acyclovir. We conducted a multicenter, randomized, open clinical trial in order to evaluate the extent of pain relief afforded by these two antiviral drugs during the acute disease phase of herpes zoster. The study group comprised 86 immunocompetent adult patients suffering from herpes zoster, who were treated with either famciclovir or valacyclovir for 7 days. Of these, 55 patients enrolled in this study within 72 h of the onset of the rash and 31 patients after 72 h of the onset. There was a significant reduction in acute herpes zoster pain with famciclovir on day 7 and at 2-3 weeks in both of these patient groups, while with valacyclovir, there was not significant reduction in pain on day 7. Of patients aged 50 years or older, there was a significantly earlier reduction in pain with famciclovir than with valacyclovir. In addition, a significant reduction in the number of patients with pain was observed as early as days 3-4 with famciclovir treatment as compared with valacyclovir treatment. We conclude that famciclovir was superior to valacyclovir in the relief of acute pain of herpes zoster. Accordingly, famciclovir is recommended for herpes zoster patients with moderate symptoms and a visual analog scale score of under 50 mm.
Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Japan.
Fumitake
F
Ono
Shinichiro
S
Yasumoto
Minao
M
Furumura
Takahiro
T
Hamada
Norito
N
Ishii
Takashi
T
Gyotoku
Mitsunari
M
Higuchi
Kenichiro
K
Inokuchi
Kazuo
K
Jyo
Hideaki
H
Koga
Ayako
A
Komai
Koji
K
Maruta
Tami
T
Mashiko
Tsukasa
T
Mihara
Hiroko
H
Miyahara
Minoru
M
Miyasato
Koichiro
K
Muto
Koichi
K
Nagase
Masakazu
M
Nagata
Hideki
H
Sakihama
Tomoko
T
Tanahashi
Atsuto
A
Ueda
Kyoko
K
Yamakawa
Chika
C
Ohata
Teruki
T
Dainichi
Daisuke
D
Tsuruta
Takashi
T
Hashimoto
D015075:2-Aminopurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D059787:Acute Pain / Q000188:drug therapy* / Q000503:physiopathology; D000212:Acyclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D044466:Asian People; D000077595:Famciclovir; D005260:Female; D006562:Herpes Zoster / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007121:Immunocompetence; D007564:Japan; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000998:Antiviral Agents; D015075:2-Aminopurine; D014633:Valine; D000077483:Valacyclovir; D000077595:Famciclovir; D000212:Acyclovir