The analysis of the evidence base of the clinical efficiency and safety of acyclovir for topical application
Keywords:herpetic infections, antiviral medicines, range of medicines, pharmaceutical market, clinical efficiency and safety of acyclovir
Herpes viruses are a family of DNA viruses, among them herpes simplex virus is the most common (HSV). An important task of modern medicine is effective and safe pharmacotherapy of viral diseases caused by HSV.
Aim. To analyze the range of drugs for the topical application in the pharmacotherapy of HSV at the pharmaceutical market of Ukraine, as well as search the evidence base of acyclovir, the leader of the pharmaceutical market.
Materials and methods. The analysis of the range of antiherpetic drugs for the topical application was performed according to the analytical system of the study of the pharmaceutical market of Ukraine “Pharmstandard” by the company “Morion”. To analyze the clinical efficiency and safety of the antiherpetic drug “Acyclovir”, the following well-known evidence-based databases were used: Cochrane Library, Trip Database, PubMed, Nice.
Results. Antiherpetic drugs for the topical application at the pharmaceutical market of Ukraine for 2016-2018 were quantitatively represented from 17 to 20 TN based on 7 INNs, mainly by foreign manufacturers. Drugs of acyclovir were the most accessible and widely presented at the market. The search for the evidence base of acyclovir for the topical application made it possible to find 7 systematic reviews devoted to the treatment of herpes diseases in the evidence-based medicine databases. Numerous studies have shown that the topical treatment with the acyclovir HSV cream on the lips and in genital herpes is less effective than its systemic application. And the use of acyclovir ointments in the treatment of herpetic keratitis is not inferior in effectiveness to the reference drugs.
Conclusions. The analysis of systematic reviews and meta-analyses has shown that the topical treatment with the acyclovir HSV cream is less effective than its systemic application. The effectiveness of the use of acyclovir ointments in the treatment of herpetic keratitis has also been proven.
Маvrov, H. I., Zаpolskii, М. E. (2013). Ukrainskyi zhurnal dermatolohii, ve-nerolohii, kosmetolohii, 2 (49), 17-22.
Howard, C. R., Fletcher, N. F. (2012). Emerging virus diseases: can we ever expect the unexpected? Emerg Microbes Infect., 1 (12), 1-9. doi: https://doi.org/10.1038/emi.2012.47.
Isakov, V. А., Arkhipova, Е. I., Isakov, D. V. (2013). Herpesvirusnye infektsii cheloveka. (2nd ed.). Saint Petersburg: SpecLit, 670.
Borak, V. P., Romanuk, L. B., Borак, V. Т., Kravets, N. Ya. (2016). Actualnaia infectolohia, 2, 53-58.
Balc’h, P. L., Pinceaux, K., Pronier, C., Seguin, Ph., Tadié, J.-M., Reizineet, F. (2020). Herpes simplex virus and cytomegalovirus reactivations among severe COVID-19 patients. Crit. Care, 24, 530. doi: https://doi.org/10.1186/s13054-020-03252-3
Pona, A., Jiwani, R. A., Afriye, F., Labbe, J., Cook, P. P., Mao, Yu. (2020). Herpes zoster as a potential complication of coronavirus disease 2019. Dermatol. Ther., Jul.13, e13930. doi: https://doi.org/10.1111/dth.13930
Isakov, V. А., Isakov, D. V. (2014). Klinicheskaia pharmakolohiia i terapia, 23 (1), 7-13.
Shmyha, T. V., Haevska, V. U., Haevskyi, V. U. (2017). Klinichna ta experimentalna patolohiia, 16 (1 (59)), 190-194. doi: https://doi.org/10.24061/1727-4338.XVI.1.59.2017.43
Vеretennikova, М. А. (2014). Fundamentalnye issledovaniia, 8 (7), 1630-1634. Available at: https://www.fundamental-research.ru/ru/article/view?id=35266
Babii, О. V., Vaschenko, К. F. (2012). Ukrainskyi medychnyi almanakh, 15 (5), 19-21.
Opstelten W., Neven A. K., Eekhof J. (2008). Treatment and prevention of herpes la-bialis. Canadian Family Physician, 54 (12), 1683–1687. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2602638/
Ching-Chi, Ch., Wang, Sh.-H., Delamere, F. M., Wojnarowska, F., Peters, M. C., Kanjirath, P. P. (2015). Interventions for Prevention of Herpes Simplex Labialis (Cold Sores on the Lips). Cochrane Database Syst Rev., 8. doi: https://doi.org/10.1002/14651858.CD010095.pub2
Heslop, R., Roberts, H., Flower, D., Jordan, V. (2016). Interventions for Men and Women With Their First Episode of Genital Herpes. Cochrane Database Syst Rev., 8. doi: 10.1002/14651858.CD010684.pub2
FlorCruz, N. V. (2015). How do topical antiviral monotherapies compare for the treatment of herpes simplex virus epithelial keratitis? Cochrane Database Syst Rev., 29 December. doi: https://doi.org/10.1002/cca.997.
Balderson, D. E., Cai, G., Fries, M. A., Kleinman, D. M., McLaughlin, M. M., Trivedi, T. M., Wurzelmann, J. I., Young, Sh. B. (2015). A systematic review and meta-analysis to compare the efficacy of acyclovir 3 % ophthalmic ointment to idoxuridine in curing herpetic keratitis by Day 7 of treatment. BMC Oph-thalmol. 15 (42). doi: https://doi.org/10.1186/s12886-015-0022-2
Kirk, R. (2015). Wilhelmus. Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis. Cochrane Database Syst Rev., 1. doi: 10.1002/14651858.CD002898.pub5
Hammer, K. D. P., Dietz, J., Lo, T. Sh., Johnson, E. M. (2018). A systematic review on the efficacy of topical Acyclovir, Penciclovir, and Docosanol for the treatment of herpes simplex labialis. EMJ Dermatol., 6 (1), 118-123. Available at: https://www.emjreviews.com/a-systematic-review-on-the-efficacy-of-topical-acyclovir-penciclovir-and-docosanol-for-the-treatment-of-herpes-simplex-labialis/
Copyright (c) 2020 National University of Pharmacy
This work is licensed under a Creative Commons Attribution 4.0 International License.Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).