Table 2.
Summary of studies examining effectiveness of oral antiviral agents for management of recurrent herpes labialis outbreaks.
| Study design | N | Outcome |
|---|---|---|
| Aciclovir | ||
| 400 mg twice daily, 12 h before ultraviolet exposure vs placebo21,71 | 147 | Aciclovir reduced frequency of attacks and duration of symptoms overall (p <0.05) |
| Fewer lesions with aciclovir (7%) vs placebo (26%) | ||
| 400 mg 5 times daily for 5 days vs placebo taken during tingling stage21,72 | 174 | Shorter duration of symptoms with aciclovir (8.1 days) vs placebo (12.5 days) (p =0.02) |
| Mean duration of pain shorter with aciclovir (2.5 days) vs placebo (3.9 days) (p = 0.02) | ||
| 800 mg twice daily for 3–7 days vs placebo73 | 237 | No significant difference in lesion occurrence with aciclovir vs placebo |
| 200 mg 5 times daily for 5 days vs placebo taken within 12 h of the onset of the first episode21,74 | 149 | No significant difference in healing time or pain duration with aciclovir vs placebo |
| 400 mg twice daily for 4 months vs placebo75 | 20 | Longer median time to recurrence with aciclovir (118 days) vs placebo (46 days) (p = 0.05) |
| 53% fewer clinical recurrences with aciclovir vs placebo (p = 0.009) | ||
| Valaciclovir | ||
| 500 mg once daily for 4 months vs placebo21,37 | 98 | Significantly longer mean time to recurrence with valaciclovir (13.1 weeks) vs placebo (9.6 weeks) (p = 0.016) |
| More patients were recurrence-free with valaciclovir (60%) vs placebo (38%) (p = 0.041) | ||
| 2 g twice daily for 1 day vs 2 g twice daily on Day 1, then 1 g twice daily on Day 2 vs placebo21,36 | 954 | Shorter median duration of episode with 1-day valaciclovir (5.0 days; p < 0.001) and 2-day valaciclovir (4.5 days; p = 0.009 vs placebo) vs placebo (5.0 days) |
| 2 g twice daily for 1 day vs 2 g twice daily on Day 1, then 1 g twice daily on Day 2 vs placebo21,36 | 902 | Shorter median duration of episode with 1-day valaciclovir (4.0 days; p < 0.001 vs placebo) and 2-day valaciclovir (4.5 days; p = 0.009 vs placebo) vs placebo (5.0 days) |
| Famciclovir | ||
| 125, 250 or 500 mg, 3 times daily for 5 days vs placebo39 | 248 | No significant difference in number of lesions between four groups. |
| Famciclovir 500 mg reduced median time to healing (4 days) vs placebo (6 days; p = 0.010). | ||
| Reduced mean lesion size in all famciclovir groups in a dose-proportional manner vs placebo | ||
| 1500 mg single dose for 1 day vs 750 mg twice daily for 1 day vs placebo38 | 701a | Reduced median healing times of primary lesions with single-dose famciclovir (4.4 days; p < 0.001 vs placebo) twice-daily famciclovir (4.0 days; p < 0.001 vs placebo) vs placebo (6.2 days) |
a
Analysis only included the 477/701 (68%) of participants who subsequently developed vesicular herpes labialis lesions during the course of treatment.