Kosuke Kawai1, Emmanouil Rampakakis2, Tsen-Fang Tsai3, Hee Jin Cheong4, Jittima Dhitavat5, Alejandro Ortiz Covarrubias6, Lin Yang2, Miguel Cashat-Cruz7, Homero Monsanto8, Kelly Johnson9, John S Sampalis10, Camilo J Acosta9. 1. Global Health Outcomes, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania, PA 19486, USA. Electronic address: kkawai8@gmail.com. 2. JSS Medical Research, St-Laurent, Quebec, Canada. 3. Department of Dermatology, National Taiwan University Hospital, Zhongzheng District, Taipei City, Taiwan. 4. Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea. 5. Clinical Infectious Disease Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Phutthamonthon District, Nakhon Pathom, Bangkok, Thailand. 6. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico. 7. Vaccines Latin America and the Caribbean, MSD Corp., Mexico City, DF, Mexico. 8. Latin America Health Outcomes Research, MSD (I.A.) Corp., Carolina, Puerto Rico. 9. Global Health Outcomes, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania, PA 19486, USA. 10. JSS Medical Research, St-Laurent, Quebec, Canada; McGill University, Montreal, Quebec, Canada.
Abstract
OBJECTIVES: The most common complication of herpes zoster (HZ) is postherpetic neuralgia (PHN), a persistent pain that can substantially affect quality of life (QoL). This analysis aimed to evaluate predictors of PHN in HZ patients. METHODS: A pooled analysis of prospective cohort studies of HZ patients aged ≥ 50 years from North America (Canada), Latin America (Brazil, Mexico, and Argentina), and Asia (Taiwan, South Korea, and Thailand) was performed. Patients within 14 days of rash onset were included. The incidence of PHN was defined as a worst pain score of ≥ 3, persisting/appearing at >90 days after rash onset. Socio-demographics, HZ disease characteristics, treatment, pain-related interference with activities of daily living, and health-related QoL were assessed. RESULTS: Of 702 patients with HZ, 148 (21.1%) developed PHN. Similar risks of PHN were observed across geographic regions. On multivariate analysis, older age, greater severity of pain at rash onset, employment status, walking problems at enrollment, and pain interference affecting social relationships were significantly associated with the development of PHN. CONCLUSIONS: In addition to older age and severe acute pain, this study suggests that impaired physical and social functioning from acute zoster pain may play a role in the development of PHN in this prospective cohort study of HZ patients from North and Latin America and Asia.
OBJECTIVES: The most common complication of herpes zoster (HZ) is postherpetic neuralgia (PHN), a persistent pain that can substantially affect quality of life (QoL). This analysis aimed to evaluate predictors of PHN in HZ patients. METHODS: A pooled analysis of prospective cohort studies of HZ patients aged ≥ 50 years from North America (Canada), Latin America (Brazil, Mexico, and Argentina), and Asia (Taiwan, South Korea, and Thailand) was performed. Patients within 14 days of rash onset were included. The incidence of PHN was defined as a worst pain score of ≥ 3, persisting/appearing at >90 days after rash onset. Socio-demographics, HZ disease characteristics, treatment, pain-related interference with activities of daily living, and health-related QoL were assessed. RESULTS: Of 702 patients with HZ, 148 (21.1%) developed PHN. Similar risks of PHN were observed across geographic regions. On multivariate analysis, older age, greater severity of pain at rash onset, employment status, walking problems at enrollment, and pain interference affecting social relationships were significantly associated with the development of PHN. CONCLUSIONS: In addition to older age and severe acute pain, this study suggests that impaired physical and social functioning from acute zoster pain may play a role in the development of PHN in this prospective cohort study of HZ patients from North and Latin America and Asia.
Authors: Joon Hyung Kim; John Diaz-Decaro; Ning Jiang; Shinn-Jang Hwang; Eun Ju Choo; Maribel Co; Andrew Hastie; David Shu Cheong Hui; Junya Irimajiri; Jacob Lee; Edward Man-Fuk Leung; Haiwen Tang; Tomomi Tsuru; Philip Watson; Zhenhua Wu; Chong-Jen Yu; Yanfei Yuan; Toufik Zahaf; Anthony L Cunningham; Anne Schuind Journal: Hum Vaccin Immunother Date: 2021-02-19 Impact factor: 3.452