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Antiviral treatment for Bell's palsy (idiopathic facial paralysis)

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Antiviral treatment for Bell's palsy (idiopathic facial paralysis). / Lockhart, Pauline; Daly, Fergus; Pitkethly, Marie; Comerford, Natalia; Sullivan, Frank.

In: Cochrane Database of Systematic Reviews, No. 4, CD001869, 2010, p. -.

Research output: Contribution to journalScientific review

Harvard

Lockhart, P, Daly, F, Pitkethly, M, Comerford, N & Sullivan, F 2010, 'Antiviral treatment for Bell's palsy (idiopathic facial paralysis)' Cochrane Database of Systematic Reviews, no. 4, CD001869, pp. -., 10.1002/14651858.CD001869.pub4

APA

Lockhart, P., Daly, F., Pitkethly, M., Comerford, N., & Sullivan, F. (2010). Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database of Systematic Reviews, (4), -. [CD001869]. 10.1002/14651858.CD001869.pub4

Vancouver

Lockhart P, Daly F, Pitkethly M, Comerford N, Sullivan F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database of Systematic Reviews. 2010;(4):-. CD001869. Available from: 10.1002/14651858.CD001869.pub4

Author

Lockhart, Pauline; Daly, Fergus; Pitkethly, Marie; Comerford, Natalia; Sullivan, Frank / Antiviral treatment for Bell's palsy (idiopathic facial paralysis).

In: Cochrane Database of Systematic Reviews, No. 4, CD001869, 2010, p. -.

Research output: Contribution to journalScientific review

Bibtex - Download

@article{5873acd0b22e4da298f609442731ff2c,
title = "Antiviral treatment for Bell's palsy (idiopathic facial paralysis)",
keywords = "Acyclovir [analogs & derivatives; therapeutic use], Antiviral Agents [therapeutic use], Bell Palsy [drug therapy; virology], Herpes Simplex [complications; drug therapy], Randomized Controlled Trials as Topic, Valine [analogs & derivatives; therapeutic use], Humans, HERPES-SIMPLEX-VIRUS, POLYMERASE-CHAIN-REACTION, VARICELLA-ZOSTER-VIRUS, DOUBLE-BLIND, ACYCLOVIR, PREDNISOLONE, EFFICACY, VALACYCLOVIR, REACTIVATION, GENICULATE",
author = "Pauline Lockhart and Fergus Daly and Marie Pitkethly and Natalia Comerford and Frank Sullivan",
year = "2010",
doi = "10.1002/14651858.CD001869.pub4",
number = "4",
pages = "--",
journal = "Cochrane Database of Systematic Reviews",
issn = "1469-493X",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Antiviral treatment for Bell's palsy (idiopathic facial paralysis)

A1 - Lockhart,Pauline

A1 - Daly,Fergus

A1 - Pitkethly,Marie

A1 - Comerford,Natalia

A1 - Sullivan,Frank

AU - Lockhart,Pauline

AU - Daly,Fergus

AU - Pitkethly,Marie

AU - Comerford,Natalia

AU - Sullivan,Frank

PY - 2010

Y1 - 2010

N2 - <p>Background</p> <p>Antiviral agents against herpes simplex virus are widely used in the treatment of idiopathic facial paralysis ( Bell's palsy), but their effectiveness is uncertain. Significant morbidity can be associated with severe cases.</p> <p>Objectives</p> <p>This review addresses the effect of antiviral therapy on Bell's palsy.</p> <p>Search strategy</p> <p>We updated the search of the Cochrane Neuromuscular Disease Group Trials Register ( December 2008), MEDLINE ( from January 1966 to December 8 2008), EMBASE ( from January 1980 to December 8 2008) and LILACS ( from January 1982 to December 2008).</p> <p>Selection criteria</p> <p>Randomized trials of antivirals with and without corticosteroids versus control therapies for the treatment of Bell's palsy.</p> <p>Data collection and analysis</p> <p>Twenty-three papers were selected for consideration.</p> <p>Main results</p> <p>Seven trials including 1987 participants met the inclusion criteria, adding five studies to the two in the previous review.</p> <p>Incomplete recovery at one year. There was no significant benefit in the rate of incomplete recovery from antivirals compared with placebo (n = 1886, RR 0.88, 95% CI 0.65 to 1.18). Inmeta-analyses with some unexplained heterogeneity, the outcome with antivirals was significantly worse than with corticosteroids (n = 768, RR 2.82, 95% CI 1.09 to 7.32) and the outcome with antivirals plus corticosteroids was significantly better than with placebo (n = 658, RR 0.56, 95% CI 0.41 to 0.76).</p> <p>Motor synkinesis or crocodile tears at one year. In single trials, there was no significant difference in long term sequelae comparing antivirals and corticosteroids with corticosteroids alone (n = 99, RR 0.39, 95% CI 0.14 to 1.07) or antivirals with corticosteroids (n = 101, RR 1.03, 95% CI 0.51 to 2.07).</p> <p>Adverse events. There was no significant difference in rates of adverse events between antivirals and placebo (n = 1544, RR 1.06, 95% CI 0.81 to 1.38), between antivirals and corticosteroids (n = 667, RR 0.96, 95% CI 0.65 to 1.41) or between the antiviral-corticosteroid combination and placebo (n = 658, RR 1.15, 95% CI 0.79 to 1.66).</p> <p>Authors' conclusions</p> <p>High quality evidence showed no significant benefit from anti-herpes simplex antivirals compared with placebo in producing complete recovery from Bell's palsy. Moderate quality evidence showed that antivirals were significantly less likely than corticosteroids to produce complete recovery.<br/> <strong>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 6. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</strong></p>

AB - <p>Background</p> <p>Antiviral agents against herpes simplex virus are widely used in the treatment of idiopathic facial paralysis ( Bell's palsy), but their effectiveness is uncertain. Significant morbidity can be associated with severe cases.</p> <p>Objectives</p> <p>This review addresses the effect of antiviral therapy on Bell's palsy.</p> <p>Search strategy</p> <p>We updated the search of the Cochrane Neuromuscular Disease Group Trials Register ( December 2008), MEDLINE ( from January 1966 to December 8 2008), EMBASE ( from January 1980 to December 8 2008) and LILACS ( from January 1982 to December 2008).</p> <p>Selection criteria</p> <p>Randomized trials of antivirals with and without corticosteroids versus control therapies for the treatment of Bell's palsy.</p> <p>Data collection and analysis</p> <p>Twenty-three papers were selected for consideration.</p> <p>Main results</p> <p>Seven trials including 1987 participants met the inclusion criteria, adding five studies to the two in the previous review.</p> <p>Incomplete recovery at one year. There was no significant benefit in the rate of incomplete recovery from antivirals compared with placebo (n = 1886, RR 0.88, 95% CI 0.65 to 1.18). Inmeta-analyses with some unexplained heterogeneity, the outcome with antivirals was significantly worse than with corticosteroids (n = 768, RR 2.82, 95% CI 1.09 to 7.32) and the outcome with antivirals plus corticosteroids was significantly better than with placebo (n = 658, RR 0.56, 95% CI 0.41 to 0.76).</p> <p>Motor synkinesis or crocodile tears at one year. In single trials, there was no significant difference in long term sequelae comparing antivirals and corticosteroids with corticosteroids alone (n = 99, RR 0.39, 95% CI 0.14 to 1.07) or antivirals with corticosteroids (n = 101, RR 1.03, 95% CI 0.51 to 2.07).</p> <p>Adverse events. There was no significant difference in rates of adverse events between antivirals and placebo (n = 1544, RR 1.06, 95% CI 0.81 to 1.38), between antivirals and corticosteroids (n = 667, RR 0.96, 95% CI 0.65 to 1.41) or between the antiviral-corticosteroid combination and placebo (n = 658, RR 1.15, 95% CI 0.79 to 1.66).</p> <p>Authors' conclusions</p> <p>High quality evidence showed no significant benefit from anti-herpes simplex antivirals compared with placebo in producing complete recovery from Bell's palsy. Moderate quality evidence showed that antivirals were significantly less likely than corticosteroids to produce complete recovery.<br/> <strong>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 6. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</strong></p>

KW - Acyclovir [analogs & derivatives; therapeutic use]

KW - Antiviral Agents [therapeutic use]

KW - Bell Palsy [drug therapy; virology]

KW - Herpes Simplex [complications; drug therapy]

KW - Randomized Controlled Trials as Topic

KW - Valine [analogs & derivatives; therapeutic use]

KW - Humans

KW - HERPES-SIMPLEX-VIRUS

KW - POLYMERASE-CHAIN-REACTION

KW - VARICELLA-ZOSTER-VIRUS

KW - DOUBLE-BLIND

KW - ACYCLOVIR

KW - PREDNISOLONE

KW - EFFICACY

KW - VALACYCLOVIR

KW - REACTIVATION

KW - GENICULATE

U2 - 10.1002/14651858.CD001869.pub4

DO - 10.1002/14651858.CD001869.pub4

M1 - Scientific review

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

IS - 4

SP - -

ER -

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  • Publisher's Final Version

    439 KB, PDF-document

    This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 6. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

DOI

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