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[Randomized controlled multi-center trial for treatment of varicella in pediatric patients with hydrochloride
Hui Yu1, Qi-rong Zhu, Zhong-lin Wang
1Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 200032, China.
Insights
Hydrochloride valacyclovir demonstrated superior efficacy compared to ribavirin in treating pediatric varicella. This antiviral medication offers a safe and effective treatment option for chickenpox in children.
Area of Science:
- Pediatric Infectious Diseases
- Antiviral Therapy
- Clinical Pharmacology
Background:
- Varicella (chickenpox) is a common viral infection in children.
- Effective antiviral treatments are crucial for managing varicella complications.
- Valacyclovir hydrochloride is a prodrug of acyclovir with potential therapeutic benefits.
Purpose of the Study:
- To assess the efficacy and safety of hydrochloride valacyclovir versus ribavirin for varicella treatment in pediatric patients.
- To compare clinical outcomes and adverse events between the two treatment groups.
Main Methods:
- A randomized, multi-center clinical trial involving 260 pediatric patients diagnosed with uncomplicated varicella.
- Patients were randomized to receive either hydrochloride valacyclovir or ribavirin for five days.
- Efficacy was evaluated using an efficacy index and effective rates on days 4 and at the end of treatment.
Main Results:
- Hydrochloride valacyclovir showed significantly higher efficacy index scores on day 4 (0.80 vs. 0.59) and at treatment end (0.86 vs. 0.70) compared to ribavirin (P < 0.01).
- Effective rates were significantly higher in the valacyclovir group (94.53% on day 4, 99.2% at end) versus ribavirin (72.7% on day 4, 88.6% at end) (P < 0.01).
- No severe adverse drug reactions were reported in either treatment group.
Conclusions:
- Hydrochloride valacyclovir is a safe, reliable, and convenient option for treating uncomplicated varicella in children.
- The drug exhibits superior efficacy compared to ribavirin in this pediatric population.
- Further research may explore optimal dosing and long-term outcomes.
Objective:
To evaluate the efficacy and safety of hydrochloride valacyclovir in treatment of varicella in pediatric patients between April 2006 and March 2007.
Methods:
A randomized controlled multi-center clinical trial was conducted in 5 pediatric centers, i.e., Children's Hospital of Fudan University, Children's Hospital of Zhejiang University, Children's Hospital of Nanjing Medical University, Pediatric Department of Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology and Children's Hospital, Chongqing University of Medical Sciences. Patients who were clinically diagnosed as varicella without any complications and were beyond 3 years of age were enrolled into the study from the out-patient clinics. The subjects were divided into two groups randomly, one was treated with hydrochloride valacyclovir, the other with ribavirin. There were 128 cases in the group treated with hydrochloride valacyclovir and 132 cases in control group treated with ribavirin. The treatment duration of two groups was five days. The clinical efficacy and safety were evaluated after the first day and the fourth day of the treatment and within three days after the end of the treatment. The clinical efficacy was assessed by efficacy index.
Results:
(1) The efficacy index on the fourth day of the therapy (0.80 +/- 0.24) in the valacyclovir group was significantly higher than that of ribavirin control group (0.59 +/- 0.37) (t = 5.42, P < 0.01). The efficacy index at the end of the treatment (0.86 +/- 0.14) in the hydrochloride valacyclovir group was also significantly higher than that (0.70 +/- 0.30) of the ribavirin control group (t = 5.43, P < 0.01). (2) In the valacyclovir and ribavirin groups, the effective rates on the fourth day of the therapy were 94.53% and 72.7% respectively (chi2) = 22.38, P < 0.01). The effective rates at the end of the therapy were 99.2% and 88.6%, respectively (chi(2) = 12.60, P < 0.01). The rates of cure of the two groups were 33.6% and 25.0% (chi2) = 2.32, P > 0.05). (3) No severe adverse drug reactions were observed in any of the two groups.
Conclusions:
The hydrochloride valacyclovir was safe, reliable and convenient in treatment of uncomplicated varicella in children.
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