A new meta-analysis published in the Journal of Dermatological Treatment suggests that brivudine, an antiviral drug, demonstrates superior efficacy in treating herpes zoster (HZ), commonly known as shingles, compared to acyclovir and valaciclovir. The study, which aggregated data from multiple randomized controlled trials, highlights brivudine's potential to shorten recovery times and reduce the incidence of postherpetic neuralgia (PHN) without increasing the risk of adverse reactions.
The varicella zoster virus (VZV) causes both chickenpox and shingles. After an initial chickenpox infection, VZV can remain dormant for years, reactivating later in life as shingles, characterized by painful, blistering rashes. The prevalence of HZ ranges from 0.2% to 2% in the general population.
Brivudine's Efficacy and Safety Profile
The meta-analysis, encompassing 4171 patients from 7 randomized controlled trials, compared brivudine treatment against non-brivudine treatments, including acyclovir and valaciclovir. The inclusion criteria for the trials included patients diagnosed with herpes zoster and evaluation of efficacy, adverse reactions, blister time, pain relief time, and PHN incidence.
Patients in the brivudine group received oral doses of 125 mg daily for one week, or 125 mg every 6 hours for 5 days. Control groups were treated with oral or intravenous acyclovir or oral valaciclovir.
The results indicated that brivudine was more effective in treating HZ and led to shorter recovery times compared to acyclovir and valaciclovir. Brivudine also demonstrated advancements in clinical efficacy and prevention of PHN occurrence, while maintaining a similar safety profile to the other antiviral treatments. Specifically, the study confirmed that brivudine effectively lowered PHN compared to the other antiviral treatments, and there were no significant differences in adverse reactions among all three treatments.
Implications and Future Research
According to the study authors, "Timely antiviral therapy against VZV is crucial in HZ treatment, that can effectively reduce formation of new lesions, accelerate healing and lower risk of and postherpetic neuralgia." Brivudine's high bioavailability (90%) and specificity against shingles make it a potentially valuable treatment option.
While the findings suggest that brivudine is a promising treatment for HZ, the authors emphasize the need for additional studies with larger participant groups to further assess its safety and efficacy. These future studies will help to solidify brivudine's role in the treatment of shingles and its potential benefits for patients.
