Copyright 1999 American Medical Association.
All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: Drs Wald and Corey's
criticisms of the table in my Editorial of antiviral therapies for the
long-term suppression of genital herpes are valid and emphasize the
need for head-to-head clinical trials of these drugs. Since these
studies are lacking, I nevertheless felt that it was necessary to
juxtapose the published clinical outcomes (with costs) of
placebo-controlled trials in a comparison table so that, at least,
providers could be assisted in forming their own conclusions when
selecting a drug. Clinical trials measure outcomes in patient
populations, but the individual patient is concerned about 1 outcome:
how many recurrences of genital herpes will I experience while taking
this drug? One point of my Editorial was to underscore the frustration
clinicians face when deciding on a drug regimen when there are no
comparison data of 3 drugs that seem to have similar activity. I, too,
look forward to the results of the famciclovir vs valacyclovir trial,
and agree that a study evaluating the effect of antiviral suppression
on transmission of HSV type 2 in serodiscordant couples is necessary.
Engel JP. Antiviral Therapies for Long-term Suppression of Genital Herpes—Reply. JAMA. 1999;281(13):1169–1170. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-13-jbk0407
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