english.prescrire.org > Spotlight > Archives : 2009 > Docosanol: barely more effective than an excipient against herpes labialis

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Docosanol: barely more effective than an excipient against herpes labialis

FEATURED REVIEWDocosanol, a fatty alcohol, was recently authorised in France for treatment of episodes of herpes labialis. It is barely or no more effective than an excipient in treating acute episodes. Lifestyle measures are still the cornerstone of herpes management.
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Abstract

  • Herpes is a contagious, recurrent viral infection of the skin and mucous membranes. In immunocompetent patients the recurrences can be troublesome but they heal spontaneously. Management is mainly based on lifestyle measures. Local application of an antiviral drug such as aciclovir has modest effects. It reduces healing time by about 2 days provided treatment is started as soon as the first symptoms appear.
  • Docosanol, a fatty alcohol, was recently authorised in France for treatment of episodes of herpes labialis.
  • A trial in 474 patients showed no tangible difference between docosanol and 5% aciclovir in reducing healing time.
  • Clinical evaluation also includes two trials versus an excipient (polyethylene glycol) including 370 and 373 patients. The median healing time was reduced by less than a day.
  • In these trials, the adverse effects of docosanol were similar to those of the excipients. In particular, docosanol cream contains excipients that can provoke allergic reactions.