A single-center randomized controlled trial of local methylcobalamin injection for subacute herpetic neuralgia.

Abstract

OBJECTIVE:

This study explored the efficacy of local methylcobalamin injection in relieving pain and improving the quality of life among subjects with subacute herpetic neuralgia.

DESIGN:

A single-center, randomized controlled trial of local methylcobalamin injection was performed.

SUBJECTS:

Ninety-eight subjects (age, ≥ 50 years) with unilateral, dermatomal pain ≥ 4 related to herpes zoster on the torso lasting for 30 days after onset of rash were enrolled.

METHODS:

Subjects were randomized to receive local methylcobalamin injection (N = 33), oral methylcobalamin (N = 33), or subcutaneous 1.0% lidocaine injection (N = 32) for 4 weeks. Worst pain severity, global impression of change, continuous spontaneous pain, paroxysmal pain, allodynia, paresthesia, interference with activities of daily living, and quality of life were assessed after 28-day treatment period.

RESULTS:

Time per group interaction and group difference on overall pain at each follow-up point were statistically significant (P < 0.001) among groups. In the injected methylcobalamin group, the overall pain (P < 0.001), continuous spontaneous pain (P < 0.05), paroxysmal pain (P < 0.05), and allodynia (P < 0.05) revealed a significant effect at each follow-up point as compared with the other groups. Twenty subjects achieved pain reduction ≥ 50%, 24 perceived worst pain ≤ 3, 24 stopped using analgesics at end point; activities of daily living and quality of life improved significantly as compared with the other groups (P < 0.001). Although both of the other groups showed a significant response after the 14-day treatment (P < 0.001) compared with the baseline, oral methylcobalamin did not provide any significantly pain relief (P > 0.05).

CONCLUSIONS:

Local methylcobalamin injection was not only efficacious in relieving pain, but also appears to be tolerable and a potential choice of treatment for subacute herpetic neuralgia.

• Authors: Gang Xu, Zhong-Wei Lv, Yan Feng, Wei-Zhen Tang, Gang Xiao Xu
• Journal: Pain medicine (Malden, Mass.) (Pain Med) Vol. 14 Issue 6 Pg. 884-94 (Jun 2013) ISSN: 1526-4637 [Electronic] England
• PMID: 23566267 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Wiley Periodicals, Inc.

Chemical References

• mecobalamin
• Vitamin B 12

Topics

• Aged
• China (epidemiology)
• Comorbidity
• Drug-Related Side Effects and Adverse Reactions (epidemiology)
• Female
• Humans
• Injections, Subcutaneous
• Male
• Neuralgia, Postherpetic (diagnosis, drug therapy, epidemiology)
• Pain Measurement (drug effects, statistics & numerical data)
• Prevalence
• Quality of Life
• Risk Factors
• Treatment Outcome
• Vitamin B 12 (administration & dosage, analogs & derivatives)