In accordance to a news source from San Francisco dated March 12, 2009, a randomized clinical trial has managed to heal cold sores more than a day faster when treated with an investigational nanoparticle emulsion that disrupts the viral membrane. Such news is great to many cold sore sufferers. It is a new break through to remedies for cold sores. Various remedies for cold sores are found in the net and continual improvements to these remedies are always welcome to many.
The news from the American Academy of Dermatology meeting said that when using the topical NB-001 on cold sore patients who are in the prodomal stage of a herpes labialis recurrence, it would speeds up the healing by almost two full days. Such news was great, as the mental stress brought by cold sores is unmeasurable especially when one got to got to face the public. The stigma of being labled as a cold sore virus patient is already stressful enough.
Below are some of the notes from the said academy meeting:
“In subjects with no lesion at baseline, the time to healing was 3.6 days, providing a significant clinical advantage over current topical and systemic agents,” the investigators concluded in a poster presentation.
“The novel physical mechanism of action renders the emergence of drug resistance highly unlikely, making NB-001 an ideal candidate for widespread treatment of common conditions, such as herpes labialis.”
More than 80% of adults have latent herpes simplex virus-1 (HSV-1) in facial ganglia. In one-third of these people, viral reactivation leads to recurrent lesions on the lips and surrounding skin.
Current topical therapies for herpes labialis are largely ineffective, and physicians are reluctant to prescribe oral medication, partly because of concerns about the emergence of drug-resistant strains of HSV-1, the authors said.
NB-001 is an investigational nanoemulsion consisting of high-energy, nanometer-size droplets containing cetylpyridinium chloride, polysorbate, and oil.
When applied to the skin, the droplets enter the epidermis and dermis, but their size prevents entry into epithelial-cell junctions, eliminating the potential for skin irritation or systemic absorption, the investigators continued.
Upon reactivation, latent HSV-1 migrates down nerve endings, existing at the dermal-epidermal junction. At that point, the nanoemulsion droplets surround the virus and fuse with the viral envelope, causing membrane disruption and viral destruction.
Investigators tested NB-001 in 919 adults with a history of HSV-1 reactivation, resulting in an average of three cold-sore outbreaks a year.
Study participants received locked medication kits containing either the NB-001 vehicle or one of three concentrations of the active nanoemulsion (0.1%, 0.3%, and 0.5%).
At the first sign of a recurrence, participants contacted investigators and received a code to unlock the medication kit and apply 200 µL of therapy five times a day for a maximum of five days.
During an outbreak, participants were assessed daily until the lesion healed or was aborted.
A total of 482 participants from 28 sites in the U.S. had cold-sore outbreaks. At the daily assessment during an outbreak, investigators rated the lesion stage as prodrome, erythema, blister, ulcer, scab, or healed. They defined healing as the return of normal skin color and no evidence of scab.
All three formulations of NB-001 led to faster healing of cold sores compared with vehicle, which was associated with a median healing time of 6.0 days and a mean of 6.7 days. However, only the 0.3% concentration significantly reduced healing time (a median of 5.0 days and a mean of 5.4, P=0.0064).
“This treatment effect is higher than that reported for the current topical therapies and is equal to that reported for high-dose oral nucleoside regimens,” the investigators said.
A subset analysis limited to patients who began treatment in the prodromal or erythematous stage showed that patients using the 0.3% nanoemulsion had a mean healing time of 3.6 days, representing about a two-day improvement over vehicle.
The findings supported prior experiments in which the 0.3% emulsion achieved the greatest penetration in cadaver tissue.
No safety issues with the nanoemulsion arose during the study.
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Thomas Wong