Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609) for Treatment of Herpes Labialis: a systematic review

ROSA, MARIA INÊS DA; SOUZA, SUÉLI L.; FARIAS, BRUNA F. DE; PIRES, PATRÍCIA D.S.; DONDOSSOLA, EDUARDO R.; REIS, MARIA EDUARDA F. DOS

doi:10.1590/0001-3765201520140701

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Articles • An. Acad. Bras. Ciênc. 87 (2 suppl) • Aug 2015 • https://doi.org/10.1590/0001-3765201520140701 linkcopy

Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609) for Treatment of Herpes Labialis: a systematic review

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We performed a systematic review with the objective of verifying the efficacy of topical use 5% Acyclovir-1% Hydrocortisone cream compared to the placebo group for herpes simplex labialis treatment. We performed a literature search using MEDLINE, Embase, BIOSIS, LILACS, Scopus, Grey literature, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS from 1990 to June 2014. We reported the outcomes using relative risk (RR) with 95% confidence intervals. The literature search yielded 180 potentially relevant publications. Reviews of the reference lists yielded two further citations. Among these papers, two were considered eligible for inclusion in this review. Both trials included 1,213 patients. A meta-analysis of these studies showed a RR = 0.77, (95% CI 0.70-0.86; p<0.001).This result suggests that an early episodic treatment with the combination of an antiviral and a steroid is beneficial for herpes simplex labialis treatment.

Acyclovir; Herpes Labialis; Hydrocortisone; ME-609; Systematic Review

First author and year of publication	Design and setting	Number of patients	Average of participants	Induction HSV	Diagnosis HSV was defined as	Initial therapy (Induction)	Participants	Results	Microbiologic analysis of the baseline	Effect size
Evans et al. 2002	Randomized, Blind four major university clinics in North America. EUA	380	≥ 18 age 39 (range, 18 to 76)	HSV Induced for radiation	a history of recurrent herpes labialis after exposure to sunlight in the previous 12 months or to have had two or more cold sores in the previous 12 months	ME-609 Cream 6 times daily For 5 days	Treatment: 190 Control: 190	The incidence of delayed classical lesions was reduced by 29% when the ME-609 combinations treatment was used compared with the incidence with the use of a placebo.	Viral swabs from 34 of 49 (69%) ME- 609-treated patients with delayed classical lesions and 54 of 70 (77%) of the placebo-treated patients with delayed classical lesions were positive for virus isolation at least once (P was not significant).	41%
Hull et al. 2011	Randomized, blind About 51sites in the USA. 4 sites in Canada	833	≥ 18 age (mean 44)		3 episodes culture-confirmed of VVC each year	ME-609 cream Twice daily for 5 days Acyclovir cream	Treatment ME-609: 601 Control: 242	The proportion of patients with nonulcerative lesions was greater in the ME-609 group (42%) compared with the acyclovir in ME-609 Vehicle (35%) and placebo (control) (26%)	Swabs were obtained from lesions in an ulcerative stage and without evidence of crusting to avoid interference with the healing process. The presence of HSV was diagnosed by the appearance of typical cytopathic effects	59%
TOTAL		1,213	32.8(range 18-65)

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