Infection and Drug Resistance (Feb 2023)
Comparison of a One- versus Two-Week Treatment with Famciclovir Upon Reductions in Pain and Occurrence of Postherpetic Neuralgia in Herpes Zoster: A Randomized Open-Label Trial
Abstract
Fen Peng,1,* Haiyang He,2,* Tianbao Xia,2 Shichao Lv2 1Department of Dermatology, Peking University Third Hospital, Beijing, People’s Republic of China; 2Department of Dermatology, Special Medical Center of Strategic Support Force of PLA, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tianbao Xia; Shichao Lv, Department of Dermatology, Special Medical Center of Strategic Support Force of PLA, No. 9 Anxiang Beili Road, Chaoyang District, Beijing, 100101, People’s Republic of China, Email [email protected]; [email protected]: Herpes zoster (HZ) is an acute herpetic skin disease resulting from the varicella-zoster virus. Typically, this condition is treated with a one-week administration of antiviral drugs, including famciclovir, which can effectively control the symptoms during the acute phase and prevent the occurrence of postherpetic neuralgia (PHN).Objective: To investigate whether a longer, two-week, regimen would enhance the capacity for famciclovir to reduce pain and prevent the occurrence of postherpetic neuralgia.Methods: HZ patients were randomly divided into two groups who were treated with famciclovir for either a one- or two-week period. Following their respective famciclovir treatments, patients were assessed for potential differences in pain intensity as evaluated at 1, 2, 4, 8 and 12 weeks post-treatment. In addition, the occurrence of postherpetic neuralgia at three months after treatment was compared between the two groups.Results: Of the 86 patients initially enrolled, 80 completed the study with N=40 randomly assigned to each of the two groups. Pain scores decreased significantly at 1, 2, 4, 8 and 12 weeks after famciclovir treatments. There were no significant differences in pain scores, and the incidence of postherpetic neuralgia occurrence between the two groups. There were no statistically significant differences in reducing pain intensity or frequency of postherpetic neuralgia between the one-week and two-week treatment protocols.Conclusion: It suggests that longer administration of famciclovir has no further benefit in the treatment of herpes zoster in our study.Keywords: herpes zoster, postherpetic neuralgia, famciclovir