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New topical treatments for herpes labialis evaluated

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – The results of an animal study show that penciclovir cream is the most efficacious of the topical treatments for herpes labialis that are newly approved by the US Food and Drug Administration or have recently been clinically evaluated.

Dr. Spotswood L. Spruance and Mark B. McKeough tested the efficacy of penciclovir cream (Denavir), n-docosanol cream (Abreva), acyclovir ointment and acyclovir cream. They infected the backs of guinea pigs with herpes simplex virus type 1 and began treatment 24 hours later. Treatment lasted for 3 to 5 days.

Penciclovir cream reduced the number of lesions by 19%, the lesion area by 38% and the lesion virus titer by 88%, the University of Utah research team reports in the September issue of Archives of Dermatology. These results were significantly better than those seen with acyclovir ointment (0%, 21% and 75% respectively) or acyclovir cream (4%, 28% and 77%).

Spruance and McKeough note that in two animal experiments, sites treated with n-docosanol cream showed no significant difference compared with control-treated sites or infected but untreated sites.

In a review of antiviral therapies for herpes labialis, published in the same issue of the journal, Dr. Stephen K. Tyring and colleagues from the University of Texas Medical Branch, Galveston, conclude that even the best of these medications are only effective in the short term.

"The greatest potential benefit for recurrent herpes genitalis or labialis may be with immune response modifiers such as resiquimod that may reduce recurrences for months after application," they suggest.

They also note that it would be prohibitively expensive to conduct a clinical study comparing all four agents evaluated by Spruance and McKeough, but that "the guinea pig model is twice as sensitive to antiviral therapies as is herpes labialis."

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