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Amenamevir is an oral once-daily antiherpesvirus drug that can be administered without dose adjustment in patients with impaired renal function. There are currently no clinical data on immunocompromised patients with herpes zoster treated with amenamevir. Therefore, an exploratory study of the efficacy and safety of amenamevir against herpes zoster in patients with immunosuppression was conducted.

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Article Synopsis
  • The study aimed to evaluate the effectiveness and tolerance of amenamevir (AMNV) in treating recalcitrant herpes simplex keratitis (HSK) caused by acyclovir-resistant herpes simplex virus 1 strains.
  • Six patients were analyzed retrospectively after failing traditional antiviral treatments, focusing on recurrence rates and visual acuity during AMNV therapy.
  • Results showed that 66% of patients did not have any recurrences on AMNV, leading to a significant reduction in HSK episodes and some improvement in vision, although the latter was not statistically significant likely due to the small sample size.
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The helicase-primase inhibitor amenamevir (AMNV) was approved for herpes zoster in Japan in 2017. The authors conducted a 1-month postmarketing observational study to evaluate the real-world safety and efficacy (cutaneous improvement and pain resolution) of AMNV in patients with herpes zoster. Of the 3453 patients registered between March 2018 and December 2020, 3110 were included in the safety analyses.

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Drug-resistant variants of herpes simplex viruses (HSV) have been reported that are not effectively treated with first-line antiviral agents. The objective of this study was to evaluate available literature on the possible efficacy of second-line treatments in HSV and the use of second-line treatments in HSV strains that are resistant to first-line treatments. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a final search was conducted in six databases on November 5, 2021 for all relevant literature using terms related to antiviral resistance, herpes, and HSV.

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Current scenario and future applicability of antivirals against herpes zoster.

Korean J Pain

January 2023

Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.

Herpes zoster (HZ) is a common disease in the aging population and immunocompromised individuals, with a lifetime risk of 20%-30% that increases with age. HZ is caused by reactivation of the varicella-zoster virus (VZV), which remains latent in the spinal dorsal root ganglia and cranial sensory ganglia after resolution of the primary VZV infection. The main focus of HZ management is rapid recovery from VZV infection as well as the reduction and prevention of zoster-associated pain (ZAP) and postherpetic neuralgia (PHN).

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