Improvement of postherpetic neuralgia after treatment with intravenous acyclovir followed by oral valacyclovir.

Abstract

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: Dianna Quan, Barbara N Hammack, John Kittelson, Donald H Gilden
• Journal: Archives of neurology (Arch Neurol) Vol. 63 Issue 7 Pg. 940-2 (Jul 2006) ISSN: 0003-9942 [Print] United States
• PMID: 16682531 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Valine
• Valacyclovir
• Acyclovir

Topics

• Acyclovir (administration & dosage, adverse effects, analogs & derivatives)
• Administration, Oral
• Aged
• Aged, 80 and over
• Antiviral Agents (administration & dosage, adverse effects)
• Drug Therapy, Combination
• Female
• Humans
• Injections, Intravenous
• Male
• Middle Aged
• Neuralgia, Postherpetic (drug therapy)
• Prospective Studies
• Treatment Outcome
• Valacyclovir
• Valine (administration & dosage, adverse effects, analogs & derivatives)