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Valomaciclovir versus valacyclovir for the treatment of acute herpes zoster in immunocompetent adults: A randomized, double‐blind, active‐controlled trial
Author(s) -
Tyring Stephen K.,
Plunkett Stephanie,
Scribner Anita R.,
Broker Robert E.,
Herrod John N.,
Handke Lane T.,
Wise John M.,
Martin Paul A.
Publication year - 2012
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.23329
Subject(s) - rash , medicine , nausea , adverse effect , vomiting , randomized controlled trial , anesthesia
Abstract Herpes zoster is a common infectious disease that can result in significant acute and chronic morbidity. The safety and efficacy of once‐daily oral valomaciclovir (EPB‐348) was evaluated for non‐inferiority to 3‐times daily valacyclovir, an approved therapy. In this study, 373 immunocompetent adults with onset of a herpes zoster rash within the preceding 72 hr were randomly assigned to receive one of four treatments for 7 days: (1) EPB‐348 1,000 mg once‐daily; (2) EPB‐348 2,000 mg once‐daily; (3) EPB‐348 3,000 mg once‐daily; or (4) valacyclovir 1,000 mg 3‐times daily. A 20% margin was the reference for non‐inferiority assessment. For the primary efficacy measure of time to complete crusting of the zoster rash by Day 28, non‐inferiority criteria were met for once‐daily EPB‐348 2,000 mg and once‐daily EPB‐348 3,000 mg compared to 3‐times daily valacyclovir. Additionally, EPB‐348 3,000 mg significantly shortened the time to complete rash crusting by Day 28 compared to valacyclovir. For secondary efficacy measures, non‐inferiority was achieved for the EPB‐348 1,000 and 2,000 mg groups compared to the valacyclovir group for time to rash resolution by Day 28. No EPB‐348 group was non‐inferior to valacyclovir for time to cessation of new lesion formation or time to cessation of pain by Day 120, though no significant differences occurred between treatment groups. Nausea, headache, and vomiting were the most common adverse events. Based on these results, additional studies are warranted to define further EPB‐348's potential as an effective and safe therapy for acute herpes zoster. J. Med. Virol. 84: 1224–1232, 2012. © 2012 Wiley Periodicals, Inc.