Back issues No.3 - 2003 / Original Study  

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Effect of Early Treatment of Acyclovir And Famciclovir on Post-herpetic Trigeminal Neuralgia
Ming-Yao Lai, Tien-Yi Tzung
Dermatol Sinica 21: 237-245, 2003

Background: The postherpetic neuralgia (PHN) is a common complication of herpes zoster. Acyclovir and famciclovir have been used to treat patients with herpes zoster for years. However, direct comparison of effectiveness on PHN between these two drugs hasn掐 been done in the past.
Objective: To compare the effectiveness of acyclovir and famciclovir on PHN and to elucidate the risk factors for PHN.
Methods: 36 patients of herpes zoster with trigeminal nerve involvement were randomly allocated to acyclovir or famciclovir treatment. Neuralgia was recorded using the visual analogue scale (VAS) before treatment and up to 3-month follow-up.
Results: Acyclovir and famciclovir are equally effective in reducing neuralgia of acute and postherpetic phase (1-month and 3-month follow-up). However, at 2-month follow-up, the severity of PHN in patients treated with famciclovir was significantly less than those treated with acyclovir. The duration of PHN, which was treated with famciclovir, was shorter than those treated with acyclovir. Besides, patients with deep stinging pain, numbness or severe acute pain (VAS score > 5) were more likely to have PHN.
Conclusions: Antiviral treatment, either with acyclovir or famciclovir, can be used to reduce acute pain of herpes zoster and postherpetic neuralgia. Compared with acyclovir, famciclovir can also shorten the duration of PHN.

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