Major Study Finds Kānuka Product Effective on Cold Sores

A unique pharmacy-backed trial, one of the largest medical studies of its kind ever undertaken in this country, has shown that honey derived from the New Zealand kānuka tree is just as effective in healing cold sores as standard pharmaceutical anti-viral treatment.

Around 30% of people suffer recurrent attacks of cold sores, a blistering infection around the lip. The topical gold standard treatment for the past thirty years has been over-the-counter aciclovir anti-viral creams such as Zovirax and Viraban. However there has been a growing call for natural alternative treatments.

Now a trial, led by researchers at the Medical Research Institute of New Zealand (MRINZ) shows that a medical-grade honey formulation derived from the native kānuka tree is just as effective in treating cold sores as standard aciclovir cream.

The results, published today in the prestigious British Medical Journal Open, has shown that a New Zealand kanuka honey formulation Honevo (90% kānuka honey and 10% glycerin) is as effective as Viraban (5% aciclovir cream) in the time it takes to reduce pain and heal a cold sore.

Lead MRINZ researcher Dr Alex Semprini says this presents patients with an evidence-based, alternative option.

“This means that patients with a preference for natural and alternative medicines, as well as pharmacists who sell these treatments, can have confidence in the effectiveness of this kānuka honey formulation as a further treatment option for cold sores” says Dr Semprini.

Dr Semprini says it’s unusual for a company selling an alternative medicine (in this case Tauranga-based HoneyLab who funded the study) to undertake a randomised trial comparing its product with a traditional pharmaceutical medicine.

“There are significant barriers relating to both cost and quality assurance in order to meet strict New Zealand regulatory requirements for clinical trials and, of course, there’s always the risk the results may prove negative” he says.

Another novel element to this study, in what’s believed to be a NZ first, is the fact all 952 patients were enrolled in the 2015-2017 trial via 76 community pharmacies nationwide.

Patients presenting to participating pharmacies within the first 72 hours of a cold sore episode were asked if they wished to take part. They were then randomly assigned either the 5% aciclovir cream Viraban (475 patients) or the medical-grade kanuka honey cream Honevo (477 patients) and asked to apply it five times daily. Patients self-recorded data for pain and cold sore progression via smart-phone or paper diaries, comparing their cold sore recovery rate to supplied photographic standards of lesion progression. Their entries were monitored for 14 days or until the cold sore fully healed. Results showed the median time for a return to normal skin was 8-9 days for both aciclovir and honey creams. No serious adverse effects were reported.

The Pharmacy Guild of NZ says its members welcomed their involvement in the trial.

“This was an ideal opportunity for community pharmacy to be directly involved in a research initiative and they can now utilise the results in future patient consultations” says Guild Chief Executive Andrew Gaudin. “Pharmacists are highly-trained health professionals and can be seen without the need to book an appointment, so they are well-placed to consult patients on minor conditions such as cold sores”.

Dr Semprini says community pharmacy involvement for this trial was pivotal.

“The Pharmacy Research Network development was a step into the unknown for the MRINZ as we traditionally conduct hospital-based clinical trials on prescription medicines” says Dr Semprini. “The enthusiasm and professionalism of both New Zealand pharmacists and participants was incredible and has created a new cost-effective, efficient and high-quality way to see if commonly-used over-the-counter treatments work. We now have the beginnings of an Australian arm to the Network for trials this year on eczema and acne and have been working with the Pharmacy Guild here to develop formal professional development credits to pharmacists who take part in such studies”.

The Health Research Council (HRC), which provides Independent Research Organisation (IRO) funding to MRINZ, says studies on every-day health problems can be seen as less exciting, but these findings are important.

‘Some dismiss cold sores as minor but they can be quite distressing” says HRC Chief Executive Professor Kathryn McPherson. “Finding new remedies, drawing on some of New Zealand’s great natural products, will be positive for patients, and should have significant commercial potential.”

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