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    Old 02-09-2003, 02:57 PM   #1
    Colbe
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    Hey guys I found some interesting information regarding the current drugs and treatment options for herpes simplex. I found this study done back in 96 by Smithkline Beecham. In a nutshell, they infected lab rats with HSV2 and then gave the rats valtrex and Famvir. The Famvir allowed only a very small portion of the virus to go into latency. Therefore, limiting recurrence rates to practically nothing. 7 years later and I can't find the follow up analysis and conclusions they were supposed to have with humans. My point is, if Famvir does have this ability and I was given generic acyclovir for my initial OB, I'd be very angry. Maybe this is why valtrex is so popularly advertised? Because it doesn't have the same capability to prevent future need for medication. I've attached the article. It's somewhat long but if you have the time its very interesting. The 2nd, 3rd, and 4th paragraphs is where it gets '' interesting ''

    Famciclovir Reduces HSV-2 Shedding and Latency

    At the recent Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Dr. S.L. Sacks, Viridae Clinical Sciences, Inc. (Vancouver, BC, Canada), and collaborators reported results from the first clinical trial of its kind showing that famciclovir (Famvir) from SmithKline Beecham Corp. (SKB; Philadelphia, PA) is effective in suppressing asymptomatic viral shedding in patients receiving the drug for suppression of genital herpes recurrences (due to herpes simplex virus type 2 infection). This suggests that famciclovir may effectively reduce the risk of contracting genital herpes in non-infected sex partners. As discussed in last month's Bulletin (p. 257), famciclovir recently received supplementary approval for suppression (prophylaxis) of recurrent genital herpes outbreaks. Dr. Sacks reported, "This study shows that patients who have frequent genital herpes outbreaks and use Famvir on a daily basis experience a marked reduction in symptomatic and asymptomatic viral shedding." Studies have shown that transmission of genital herpes most often occurs during asymptomatic shedding--between recurrences when affected patients may not be taking adequate precautions. This randomized, double-blind, placebo-controlled, parallel-group study enrolled 177 women with frequently recurring genital herpes who received famciclovir or placebo treatment for four months. Patients swabbed their genital areas daily for viral testing and recorded lesions and other symptoms in a diary. "Patients treated with Famvir had approximately an 80-90 percent reduction in days with asymptomatic viral shedding and an 87-97 percent reduction in days with symptomatic viral shedding, compared with placebo."

    The efficacy of famciclovir suppression therapy to reduce viral shedding, presumably directly associated with the risk for transmission of HSV-2, may give it an advantage over valacyclovir and acyclovir, both drugs from Glaxo Wellcome Inc., which are also approved for suppression of genital herpes episodes. SKB may pursue an additional indication for famciclovir, reduction of risk of sexual transmission. It remains to be seen whether FDA and other regulatory authorities would grant this based on surrogate marker-type data showing reduction in viral shedding. Famciclovir may offer other advantages, when compared with (val)acyclovir, including the ability to prevent further genital recurrences (perhaps essentially curing the disease) after treatment of initial outbreaks, as discussed in the October 1996 Bulletin (p. 264).

    Along these lines, Dr. H.J. Field, Cambridge University Veterinary School, at ICAAC updated his preclinical findings in mice showing that famciclovir when administered during initial HSV infection is more effective than valacyclovir in reducing the number of cells containing latent HSV, even when treatment is delayed for several days. Famciclovir (but not valacyclovir) treatment during acute HSV infection was shown to prevent viral latency and/or subsequent reactivation. Latently infected cells were visualized using a new technique involving staining of LAT protein produced by dormant virus in latently infected cells. Mice were treated for 10 days with either famciclovir or valacyclovir starting within one or two days after infection. Compared to untreated controls, only a few cells in famciclovir-treated mice had latent HSV vs. 40% of cells in valacyclovir-treated mice.

    Dr. Field concluded, "Famciclovir's high bioavailability combined with its ability to maintain high concentrations of its active form [penciclovir] inside infected cells for a long period of time may explain its benefits over other antivirals." Famciclovir significantly reduced latency even when treatment was started up to five days after infection of mice with either HSV-1 or HSV-2. Similar famciclovir-induced reduction of viral latency has been observed in murine neural tissues. These results were achieved using direct comparisons of oral famciclovir and valacyclovir in mice achieving drug levels comparable to those achieved in humans during therapy. Based on these results, an ongoing double-blind, randomized, parallel group clinical trial sponsored by SKB involving 300 patients at 50 sites worldwide (25 U.S. sites) is testing whether 10-day famciclovir treatment of initial outbreaks can eliminate further outbreaks.


     
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    Old 02-09-2003, 08:07 PM   #2
    singlerose
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    I found this to be a very interesting read.. seeing as though I've just been diagnosed with having Herpes. Actually, I have a follow up visit on Feb. 14, with my OBGYN. She prescribed the 1g Valtrex 2xs daily for me for 10 days.. but I am wondering if Famvir is available to us.. and if it works THIS well.. should I ask her about this therapy? Like I said.. that article was very very very interesting and very encouraging in light of the fact this first initial OB for me has been soooooooo excruciatingly painful.. I'm pretty much through most of the pain right now.. going back in to "discomfort" zone.. but as someone who knows she has Herpes.. I want to know my options for treatment. Thanks for the information!
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    Old 02-09-2003, 09:07 PM   #3
    Colbe
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    singlerose,

    Yes, Famvir has been available in the U.S. for a few years now. However, I think doctors prefer the generic acyclovir and valtrex. I'm curious to find out what the statistics are as far as prescription % differences between acyclovir, valtrex, and famvir. We can't make assumptions based on this one study but its ''interesting''. It sounds like after the primary, the damage is already done though. Personally, I wish I was prescribed Famvir for my initial OB, but that's hindsight for you.

     
    Old 02-13-2003, 06:54 PM   #4
    MikeGinny
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    This study is interesting, but I would like to see some replication before I believe it. Since both drugs use essentially identical mechanisms, I don't see how this would be the case. Having said that, if the study is valid, then the study is valid.

    I will see if I can find the full text of the study in our library.

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    [This message has been edited by MikeGinny (edited 02-13-2003).]
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