Effect of foscarnet cream on experimental UV radiation-induced herpes labialis

Abstract

A topical 3% foscarnet cream formulation was evaluated for its ability to treat experimental UV radiation (UVR)-induced herpes labialis in a double-blind study. Healthy adult volunteers with a history of sunlight-induced herpes labialis were randomly assigned at four centers to receive either foscarnet cream (n = 152) or a vehicle control (n = 150). Following measurement of the minimal erythematous dose (MED), the subjects' lips were exposed to 4 MEDs of UV light. Subjects applied the cream on the UVR-exposed area approximately eight times daily beginning immediately after UVR exposure and continuing for 7 days, or until all lesions had a minimum of 4 days of treatment. There were no significant differences between groups in the percentages of subjects that developed any lesion, aborted lesions (did not progress beyond a papule), immediate lesions (developed within 48 h of UVR), or delayed classic lesions (developed 48 h to 7 days after UVR). Treatment with foscarnet significantly reduced the mean lesion area (49 versus 81 mm2; P = 0.01), the maximum lesion area (80 versus 141 mm2; P = 0.01), and the time to healing (P = 0.03) of the delayed classic lesions (n = 78). There was also a trend for a decrease in the mean duration of these lesions (156 versus 191 h; P = 0.08) and the duration of pain (3.9 versus 4.3 days; P = 0.06) in foscarnet-treated subjects. There were no clinically significant adverse reactions. These data suggest that topical foscarnet can be efficacious and deserves further evaluation for the treatment of herpes labialis.

Peroral Famciclovir in the Treatment of Experimental Ultraviolet Radiation–Induced Herpes Simplex Labialis: A Double‐Blind, Dose‐Ranging, Placebo‐Controlled, Multicenter Trial

“…In typical experimental UVR exposure protocols to date, therapy was begun before clinical lesion onset [19,20,28]. Initiation of therapy with an effective parenteral agent, such as acyclovir capsules, before or at the time of UVR exposure, completely prevents delayed lesions; however, if treatment is begun 48 h after UVR exposure, delayed lesions are not prevented but are less severe [19].…”

“…UVR-induced lesions tend to be more severe, providing a larger "target" to test chemotherapy [27]. Experimental UVR-induced lesions can be divided into delayed and immediate lesions: The delayed lesions can be completely prevented with prophylactic antiviral therapy and have responded with reduced lesion severity to episodic treatment with topical or systemic antiviral agents [19,20,28]. Post-UVR immediate lesions have not responded to antiviral treatment.…”

“…In experimental UVR-induced herpes labialis, patients may develop "immediate lesions" within 6-48 h post-UVR exposure or "delayed" lesions 3-7 days after exposure [19]. Immediate lesions are of uncertain pathogenesis and have not responded to antiviral drugs in prior studies [19,20]. Delayed lesions are thought to develop from virus reactivation in the trigeminal nerve, centrifugal axonal virus transport, and seeding of the epidermis in the irradiated zone.…”

Novel drug delivery approaches on antiviral and antiretroviral agents

“…[59] An experimental studies was done on healthy adult human volunteer, have a history of sunlight-induced Herpes labialis. Lips of these subjects were then exposed to ultra violet light and immediately after exposure, cream was applied approximately eight times daily for 7 days.…”

Oral and perioral herpes simplex virus type 1 (HSV‐1) infection: review of its management*

“…Randomized controlled trials of topical foscarnet 3% cream, applied four times daily, vs placebo have demonstrated that it can reduce the duration of virus shedding, development of vesicles and duration of ulcers (Lawee et al , 1988; Bernstein et al , 1997).…”