 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Herpes / November 2004Long-term effectiveness of Valtrex/acyclovir?
Hey all - Seems like GSK doesn't know, but has anybody taken acyclovir or any variant long-term, IE at least 2 or 3 years? Either suppressive or outbreak dosing would be interesting to know (actually, both would). The reason I'm asking is, the data _seems_ to suggest that the longer you take it, the less effective it is. Why is this? Is this a result of the particular HSV strain you've contracted mutating as a result of resistance? Thanks in advance > Hey all - > > Seems like GSK doesn't know, but has anybody taken acyclovir or any > variant long-term, IE at least 2 or 3 years? Either suppressive or > outbreak dosing would be interesting to know (actually, both would). Im fairly certain thats there is 15 year suppressive therapy out there somewhere, I've certainly put out old 5 year data citations here in the past. I have to say Ive not heard any general rule that efficacy goes off. Archives of Ophthalmology. Vol. 121(12)(pp 1702-1704), 2003. lists 18month use and efficacy remaining. Thats oral use for ocular herpes. This paper; Tyring SK. Baker D. Snowden W. Journal of Infectious Diseases. Vol. 186(SUPPL. 1)(pp S40-S46), 2002. Date of Publication: 15 OCT 2002. Valacyclovir for herpes simplex virus infection: Long-term safety and sustained efficacy after 20 years' experience with acyclovir. is the most recent review I can find, it makes the following statement in its abstract 'Long-term use of acyclovir for up to 10 years for HSV suppression is effective and well tolerated.' Try this URL http://www.journals.uchicago.edu/JID/journal/issues/v186nS1/020174/020174.html I can get to it but Im not sure if its generally available or because of my work access but its the full text of the Tyring article. Its linked direct of Pubmed which is public access so it should either let you in or block you by domain. There should be a PDF option somewhere - on the sidebar I think. This one looks at Valacyclovir over a one year period, Baker DA. Blythe JG. Miller JM. Once-daily valacyclovir hydrochloride for suppression of recurrent genital herpes. Obstetrics & Gynecology. Vol. 94(1)(pp 103-106), 1999 OK below your threshold of 2-3 years but over one year they saw no drop off at all.... Ah bingo.... Goldberg LH. Kaufman RH. Kurtz TO. Conant MA. Eron LJ. Batenhorst RL. Boone GS. Baker D. Blythe J. Crumpacker C. Fife K. Frost P. Gelb L. Hale R. Herndon J. Kaplowitz L. Kurtz T. Mertz G. Mills J. et al. Continuous five-year treatment of patients with frequently recurring genital herpes simplex virus infection with acyclovir. Journal of Medical Virology. Vol. 41(SUPPL. 1)(pp 45-50), 1993. Thats a report I've cited here before - it works...though after 3 or so years it suggests that episodic and suppressive therapy converge in effectiveness which is interesting. I've seen papers at conferences listing longer term use of the drug but they aren;t in databases like pubmed or are buried under slightly more obscure titles and I doubt I've still got the paperwork lying around (though I might somewhere) Valacyclovir doesnt seem to have anything like the long term study I've seen on acyclovir (we've got 20 years of studies with that one) > Why is this? Is this a result of the particular HSV strain you've > contracted mutating as a result of resistance? Resistance was the big worry in the field. The data coming out really sugggests it is not really an issue. The basic lifecycle of the virus (infect, set up reservoir, no further infections and recurrences from the reservoir) really leaves a source of virus that is sensitive and even if you can generate resistant virus in drug therapy (a transmission risk and presumably one way it colonises other people) you personal virus seems to remain sensitive since the template it comes off doesnt change. Fair amount of that is guesswork and extrapolation as its one area people are still trying to figure out - the 'resistance is not on the increase' is relatively recent data so what how why and so on are still under heavy discussion. Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 Tim, thanks! Very, very helpful information. I appreciate the time you spent responding very much. >>Hey all - >> [quoted text clipped - 78 lines] > When playing rugby, its not the winning that counts, but the taking apart > ICQ: 5178568 Anonymous, Why does it seem that GSK doesn't know?? I have an online buddy that has been on acyclovir for years and years. She goes by the name "Grace." You are more than welcome to come on over to Picking Up the Pieces and ask her about it. Here's link for Picking Up the Pieces: http://health.groups.yahoo.com/group/PickingUpThePieces/ It's one of the largest Herpes and HPV support groups combined on Yahoo Groups. Also, this newsgroup has slowed down quite a bit over the last couple of years so you might want to think about coming over for the simple fact that you will get lots of opinions and experiences shared by the members over there. I don't know what data you are looking at. Is there a link you can share because I have not heard of Herpes Antivirals becoming less effective over the years. I don't feel that information is correct. I will tell you that the longer you have the virus the less frequent your flare ups become if you actually get flare ups. I wouldn't worry about HSV strains because they are not really looked at and even if they were it would be minimal and rare. Hang in there.. - Angela :)  SignatureSTD Message Board: http://www.yoshi2me.com/ipw-web/bulletin/bb/index.php Picking Up the Pieces: http://health.groups.yahoo.com/group/PickingUpThePieces/ SSNA Scoop: http://health.groups.yahoo.com/group/SSNA-Scoop/ Herpes Simplex Help Blog: http://herpes-help.blogspot.com/ > Hey all - > [quoted text clipped - 9 lines] > > Thanks in advance > Anonymous, > [quoted text clipped - 16 lines] > > - Angela :) Well, I was specifically referring to the marketing on their commercials (both websites and TV ads), in which "In fact, in a one-year clinical study among people with genital herpes who had six or more outbreaks a year and took VALTREX--at six months, over half were outbreak-free. After one year, a third were outbreak-free." (Source: Valtrex.com) That's interesting to me, and I'm wondering why, at least for this particular study. >> Anonymous, >> Why does it seem that GSK doesn't know?? I have an online buddy that has >> been on acyclovir for years and years. She goes by the name "Grace." You are [quoted text clipped - 12 lines] >> really looked at and even if they were it would be minimal and rare. Hang in >> there.. >> - Angela :) >Well, I was specifically referring to the marketing on their commercials >(both websites and TV ads), in which "In fact, in a one-year clinical >study among people with genital herpes who had six or more outbreaks a >year and took VALTREX--at six months, over half were outbreak-free. >After one year, a third were outbreak-free." (Source: Valtrex.com) >That's interesting to me, and I'm wondering why, at least for this >particular study. It's impossible to derive any indication of Valtrex efficacy over time from the statement you quoted. I believe you are mis-understanding something about statistics. It would be quite unlikely that the people who didn't have outbreaks in the first six months would never have outbreaks after the six months. Indeed, if, say, half the group had one outbreak in the first six months of Valtrex use, and then, in the second six months of the study, the *other* half of the group had one outbreak each, the statement by the Valtrex people would have to be modified to say "After one year, zero were outbreak-free," while the actual reduction in outbreaks would be a consistent +80% or so. Hope that helps, Mike To add to what Mike had to say.. Suppression with Valtrex reduces asymptomatic shedding, flare ups and frequency of flare ups. By how much depends on each person because we are all different and herpes doesn't react the same way in all people that take Valtrex to treat their herpes. As for talking to others that have been on suppression for many many years.. I know several with no problems. - Angela :) www.yoshi2me.com >>> Anonymous, > [quoted text clipped - 55 lines] > > Mike > Well, I was specifically referring to the marketing on their commercials > (both websites and TV ads), in which "In fact, in a one-year clinical > study among people with genital herpes who had six or more outbreaks a > year and took VALTREX--at six months, over half were outbreak-free. > After one year, a third were outbreak-free." (Source: Valtrex.com) Erm that is, i think, because they are using a leakage analysis....f someone gets an outbreak they come out of the count. Drug treatment isnt a guarantee of no outbreaks forever, it reduces he frequency. As such these people had 6 or more outbreaks, they take the drug and at 6 months still 50% of them had not had an outbreak of any kind. In a further 6 months then 1/3 of the original starters (so 2/3 of the 50% who got to 6 months outbreak free) were STILL outbreak free. Thats not the drug going off thats just the fact that there is a cumulative permanent dropout of triallist from the mathematical set of 'those who at this time have not yet had an outbreak from the start fothe trial'. Compared to at one year expecting all of them to have had an outbreak (well 6 actually) thats a BIG difference. Get one outbreak and you are out of that count....still one outbreak in 12months when you were getting 6+ indicates some kind of drug effect. It is however limited in that it doesn't describe how many in th control arm were in the same position of not having had an outbreak (ie the natural tendency of the virus to shut down to some extent or other over time), nor does it give a frequency change (did those that drop out just get th one outbreak in the year or revert to a pattern of 6 per year, or somewhere in between). Tim -- When playing rugby, its not the winning that counts, but the taking apart ICQ: 5178568 |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.