Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine “Is famciclovir superior to valacyclovir as a treatment for recurrent genital herpes in reducing outbreak duration and frequency?”

STUDY DESIGN: This review is based on three double-blind, randomized controlled trials (RCTs) published in 2006, 2008, and 2009. The studies compared the efficacy and safety of famciclovir (FCV) vs. valacyclovir (VCV) in the treatment of genital herpes.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and found using PubMed.

OUTCOMES MEASURED: The effectiveness of famciclovir and valacyclovir was evaluated based on the proportion of patients with aborted lesions, the time to resolutions of lesions of active infection and all associated symptoms, the time to next reoccurrence, and the proportion of patients with a recurrence.

RESULTS: All three studies found that there were no significant differences in efficacy or safety in terms of clinical disease manifestations between FCV and VCV. Median time to healing of herpes lesions was similar in both groups (4.25 days vs. 4.08 days), and about one third of patients in both groups experienced aborted lesions. A follow-up study showed similar times to next recurrence (33.5 days vs. 38 days). Values for evaluating frequency of recurrences proved to be similar as well, with 34% of the FCV group and 28% of the VCV group experiencing an outbreak within a 16-week post-treatment period, and the mean number of recurrences being 0.11 and 0.10, respectively.

CONCLUSIONS: The results of the three RCTs demonstrate that famciclovir is equally effective compared to valacyclovir, but does not appear to be superior in treating genital herpes. However, the shorter dosing schedule of famciclovir for herpes recurrence may provide a more convenient treatment option for some patients, and further comparative studies are warranted to investigate whether improvements in virologic disease manifestations from previous in vivo murine studies translate into clinically meaningful results.