低剂量瓦拉基克洛维尔在疹中 Zoster Ophthalmicus:Zoster眼病随机临床试验
Elisabeth J Cohen1, Andrea B Troxel2, Mengling Liu2
1Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York.
JAMA ophthalmology
|March 6, 2025
概括
在一项为期12个月的试验中,对疹眼科 (HZO) 的抑制性瓦拉基克洛维尔治疗没有显著延迟初始角质炎或皮炎. 然而,它在减少复发发作和18个月终点上显示出好处.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
- 抗病毒疗法 抗病毒疗法
背景情况:
- 疹眼 (HZO) 需要有效的管理,以防止眼部并发症.
- 需要在HZO中长期抑制性抗病毒治疗的高质量证据.
研究的目的:
- 评估12个月抑制性瓦拉基克洛维尔在预防HZO患者新发或恶化的脑膜角质炎 (SK),内皮角质炎 (EK),皮膜炎或树状上皮角质炎 (DEK) 的疗效.
- 评估治疗效益在18个月后是否持续.
主要方法:
- 一个随机的,双面罩的,安慰剂控制的试验 (Zoster眼病研究 - ZEDS) 涉及527名具有免疫能力的成年人,有HZO病史.
- 参与者每天接受瓦拉西克洛维尔 (1000毫克) 或安慰剂12个月.
- 主要结局:在12个月内出现特定的眼部炎症状况的时间.
主要成果:
- 主要结局在12个月后没有达到统计学意义 (HR 0.77,P=0.09).
- 在18个月的二次终点 (HR 0.73,P=0.03) 观察到显著的益处.
- 在12个月和18个月后,瓦拉基克洛维尔显著减少了多次角质炎或皮炎的发作 (P=0.02对两者).
结论:
- 虽然没有满足最初疾病发生的初级终点,但12个月的抑制性瓦赛克洛维尔治疗在减少HZO的复发性眼球炎症方面表现出有效性.
- 这些发现支持考虑一年的抑制性瓦拉基克洛维尔用于管理HZO,以减少炎症发作的频率.
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