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A systematic review and critical appraisal of famciclovir treatment of herpes zoster Bassett, Kenneth, 1952-; Green, C. J. (Carolyn Joanne), 1956-; Wright, James M.

Abstract

Objective: to determine the efficacy and effectiveness of famciclovir versus placebo for the treatment of herpes zoster. Design: systematic review and critical appraisal of randomised trials comparing the efficacy of famciclovir with placebo in adults with herpes zoster. Setting: outpatient clinics in the United States, Canada, and Australia. Subjects: adults with uncomplicated herpes zoster. Interventions: famciclovir 500 mg & 750 mg Main outcome measure: incidence, severity and patient-days of post herpetic neuralgia. Results: The one published report which met the inclusion criteria was of poor methodological quality. Data analysis was incomplete and incongruous. Famciclovir increased the incidence of post herpetic neuralgia from 38% in the placebo arm to 44% in the famciclovir 500 mg and 50% in the famciclovir 750 mg arms respectively. The difference was statistically significant (p<0.004) in the group of patients over age 50 in the famciclovir 750 mg arm. Patients over age 50 also had similar patient-days of neuralgia: 3689 days (35%) placebo versus 2867 days (27%) famciclovir 750 mg. This non-statistically significant 8% difference in patient-days contrasts with the dramatic 50% reduction in post herpetic neuralgia duration reported in the published study. Conclusion: Evidence that famciclovir provides a therapeutic advantage over placebo for treatment of herpes zoster is incomplete, and inconclusive. The results demonstrate the importance of careful critical appraisal of published trial reports before acceptance, and the need for further trials in this area.

Item Metadata

Title
A systematic review and critical appraisal of famciclovir treatment of herpes zoster
Alternate Title
BCOHTA 98:11J
Creator
Bassett, Kenneth, 1952-; Green, C. J. (Carolyn Joanne), 1956-; Wright, James M.
Contributor
University of British Columbia. Centre for Health Services and Policy Research
Publisher
British Columbia Office of Health Technology Assessment (BCOHTA)
Date Issued
1998-09
Description
Objective: to determine the efficacy and effectiveness of famciclovir versus placebo for the treatment of herpes zoster. Design: systematic review and critical appraisal of randomised trials comparing the efficacy of famciclovir with placebo in adults with herpes zoster. Setting: outpatient clinics in the United States, Canada, and Australia. Subjects: adults with uncomplicated herpes zoster. Interventions: famciclovir 500 mg & 750 mg Main outcome measure: incidence, severity and patient-days of post herpetic neuralgia. Results: The one published report which met the inclusion criteria was of poor methodological quality. Data analysis was incomplete and incongruous. Famciclovir increased the incidence of post herpetic neuralgia from 38% in the placebo arm to 44% in the famciclovir 500 mg and 50% in the famciclovir 750 mg arms respectively. The difference was statistically significant (p<0.004) in the group of patients over age 50 in the famciclovir 750 mg arm. Patients over age 50 also had similar patient-days of neuralgia: 3689 days (35%) placebo versus 2867 days (27%) famciclovir 750 mg. This non-statistically significant 8% difference in patient-days contrasts with the dramatic 50% reduction in post herpetic neuralgia duration reported in the published study. Conclusion: Evidence that famciclovir provides a therapeutic advantage over placebo for treatment of herpes zoster is incomplete, and inconclusive. The results demonstrate the importance of careful critical appraisal of published trial reports before acceptance, and the need for further trials in this area.
Subject
Health technology; Medical technology; Herpes Zoster -- drug therapy; 2-Aminopurine -- analogs & derivatives; 2-Aminopurine -- therapeutic use
Genre
Report
Type
Text
Language
eng
Date Available
2014-10-06
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivs 2.5 Canada
DOI
10.14288/1.0045260
URI
http://hdl.handle.net/2429/50616
Affiliation
Family Practice, Department of; Anesthesiology, Pharmacology and Therapeutics, Department of; Non UBC; Medicine, Faculty of; Population and Public Health (SPPH), School of
Peer Review Status
Unreviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/2.5/ca/
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Attribution-NonCommercial-NoDerivs 2.5 Canada