BACKGROUND:Postherpetic neuralgia (PHN) is a complication of shingles (herpes zoster), a painful rash due to varicella-zoster virus reactivation. Studies of patients with PHN and zoster sine herpete (radicular pain without rash) support the notion that low-grade viral ganglionitis contributes to pain. If chronic pain reflects active infection, then antiviral therapy may help patients with PHN. OBJECTIVE: To determine whether antiviral treatment helps reduce PHN-associated pain. DESIGN: Prospective, open-label phase I/II clinical trial. SETTING:Tertiary care university hospital. PATIENTS: Fifteen patients with moderate to severe PHN. INTERVENTIONS:Intravenous acyclovir at a dosage of 10 mg/kg every 8 hours for 14 days followed by oral valacyclovir at a dosage of 1000 mg 3 times per day for 1 month. MAIN OUTCOME MEASURE: Numeric Rating Scale for Pain score. RESULTS: As defined by a decrease of 2 or more points on the Numeric Rating Scale for Pain, 8 (53%) of 15 patients reported improvement. CONCLUSION: Clinical improvement reported by most of our patients warrants further investigation in a larger, randomized, double-blind, placebo-controlled trial.
RCT Entities:
BACKGROUND: Postherpetic neuralgia (PHN) is a complication of shingles (herpes zoster), a painful rash due to varicella-zoster virus reactivation. Studies of patients with PHN and zoster sine herpete (radicular pain without rash) support the notion that low-grade viral ganglionitis contributes to pain. If chronic pain reflects active infection, then antiviral therapy may help patients with PHN. OBJECTIVE: To determine whether antiviral treatment helps reduce PHN-associated pain. DESIGN: Prospective, open-label phase I/II clinical trial. SETTING: Tertiary care university hospital. PATIENTS: Fifteen patients with moderate to severe PHN. INTERVENTIONS: Intravenous acyclovir at a dosage of 10 mg/kg every 8 hours for 14 days followed by oral valacyclovir at a dosage of 1000 mg 3 times per day for 1 month. MAIN OUTCOME MEASURE: Numeric Rating Scale for Pain score. RESULTS: As defined by a decrease of 2 or more points on the Numeric Rating Scale for Pain, 8 (53%) of 15 patients reported improvement. CONCLUSION: Clinical improvement reported by most of our patients warrants further investigation in a larger, randomized, double-blind, placebo-controlled trial.
Authors: Lena J Al-Dujaili; Patrick P Clerkin; Christian Clement; Harris E McFerrin; Partha S Bhattacharjee; Emily D Varnell; Herbert E Kaufman; James M Hill Journal: Future Microbiol Date: 2011-08 Impact factor: 3.165
Authors: Manish Kumar; Herbert E Kaufman; Christian Clement; Partha S Bhattacharjee; Tashfin S Huq; Emily D Varnell; Hilary W Thompson; James M Hill Journal: Invest Ophthalmol Vis Sci Date: 2010-04-14 Impact factor: 4.799
Authors: Maria A Nagel; Alexander Choe; Randall J Cohrs; Igor Traktinskiy; Kyle Sorensen; Satish K Mehta; Duane L Pierson; Stephen K Tyring; Kassie Haitz; Catherine Digiorgio; Whitney Lapolla; Don Gilden Journal: J Infect Dis Date: 2011-09-15 Impact factor: 5.226
Authors: Don Gilden; Maria A Nagel; Ravi Mahalingam; Niklaus H Mueller; Elizabeth A Brazeau; Subbiah Pugazhenthi; Randall J Cohrs Journal: Future Neurol Date: 2009-01-01
Authors: Anne A Gershon; Judith Breuer; Jeffrey I Cohen; Randall J Cohrs; Michael D Gershon; Don Gilden; Charles Grose; Sophie Hambleton; Peter G E Kennedy; Michael N Oxman; Jane F Seward; Koichi Yamanishi Journal: Nat Rev Dis Primers Date: 2015-07-02 Impact factor: 52.329