Significant treatment benefits seen at 18 months; in addition, risk for experiencing subsequent end points lower with valacyclovir
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Oct. 23, 2024 (HealthDay News) — One year of valacyclovir is beneficial for patients with herpes zoster ophthalmicus (HZO), according to a study presented at the annual meeting of the American Academy of Ophthalmology, held from Oct. 18 to 21 in Chicago.
Elisabeth Cohen, M.D., from the NYU Grossman School of Medicine and NYU Langone Health in New York City, and colleagues conducted a multicenter, randomized controlled trial involving immunocompetent adults with HZO. A total of 527 participants were randomly assigned to suppressive valacyclovir 1,000 mg daily or placebo (266 and 261 individuals, respectively) for one year of treatment and were assessed at 18-month follow-up.
The researchers observed no significant treatment benefit in terms of reducing new/worsening stromal keratitis, iritis, dendriform epithelial keratitis, or endothelial keratitis at the primary end point of 12 months of treatment, but significant benefit was seen for the secondary end point of new or worsening eye disease at 18 months (hazard ratio, 0.74). Participants receiving valacyclovir versus placebo had a significantly lower risk for experiencing subsequent end points (i.e., multiple disease flare-ups; hazard ratios, 0.70 and 0.72 at 12 and 18 months, respectively). Participants on valacyclovir also had a significant reduction in the dose of neuropathic medications at 12 and 18 months.
“Our results support changes in clinical practice, with suppressive valacyclovir recommended to reduce new, worsening, and repeated episodes of eye disease, as well as need for neuropathic pain medication in HZO patients and in those with shingles-related pain,” Cohen said in a statement.
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