Lebrun-Vignes Bénédicte, Bouzamondo Anissa, Dupuy Alain, Guillaume Jean-Claude, Lechat Philippe, Chosidow Olivier
Department of Pharmacology, Hôpital Pitié-Salpêtrière, Paris, France.
J Am Acad Dermatol. 2007 Aug;57(2):238-46. doi: 10.1016/j.jaad.2007.02.008. Epub 2007 Apr 9.
Efficacy of oral antiviral therapies, ie, acyclovir, valacyclovir (VACV), and famciclovir, for suppression of recurrent genital herpes was studied at different doses and regimens.
We sought to compare the clinical efficacies of the different oral antiviral drugs prescribed prophylactically to suppress recurrent genital herpes.
MEDLINE and EMBASE databases were searched for articles on genital herpes and selected antiviral drugs. The selected trials were: parallel randomized clinical trials testing prophylactic oral antiviral treatment of genital herpes versus placebo in immunocompetent and nonpregnant patients.
Fourteen randomized clinical trials were selected, including a total of 6158 patients. The global relative risk of developing at least one recurrence during the study was reduced by 47% (95% confidence interval 45%-49%) in antiviral drug groups compared with the placebo. The best evaluated regimens, with comparable efficacies, were given twice daily, ie, acyclovir (400 mg twice daily), VACV (250 mg twice daily), and famciclovir (250 mg twice daily), or once daily (VACV 500 mg).
The only end point available for all the studies was the number of patients presenting at least one recurrence of genital herpes during the observation period.
The results of this first meta-analysis confirmed the high clinical efficacy of oral acyclovir, VACV, or famciclovir for prophylaxis against recurrent genital herpes.
研究了口服抗病毒疗法，即阿昔洛韦、伐昔洛韦（VACV）和泛昔洛韦，在不同剂量和给药方案下对复发性生殖器疱疹的抑制作用。
我们试图比较预防性使用不同口服抗病毒药物抑制复发性生殖器疱疹的临床疗效。
检索MEDLINE和EMBASE数据库中关于生殖器疱疹和所选抗病毒药物的文章。所选试验为：在免疫功能正常且未怀孕的患者中，比较口服抗病毒药物预防性治疗生殖器疱疹与安慰剂的平行随机临床试验。
共入选14项随机临床试验，包括6158例患者。与安慰剂组相比，抗病毒药物组在研究期间发生至少一次复发的总体相对风险降低了47%（95%置信区间45%-49%）。评估效果最佳且疗效相当的给药方案为每日两次给药，即阿昔洛韦（每日400 mg，分两次服用）、伐昔洛韦（每日250 mg，分两次服用）和泛昔洛韦（每日250 mg，分两次服用），或每日一次给药（伐昔洛韦500 mg）。
所有研究唯一可用的终点是在观察期内出现至少一次生殖器疱疹复发的患者数量。
这项首次荟萃分析的结果证实，口服阿昔洛韦、伐昔洛韦或泛昔洛韦预防复发性生殖器疱疹具有很高的临床疗效。
