Antiviral treatment for preventing postherpetic neuralgia

摘要: Background Postherpetic neuralgia (PHN) is a painful and refractory complication of herpes zoster. Treatments are either partially or totally ineffective for many people with PHN. Antiviral agents, used at the time rash, have been proposed as an intervention to prevent development This first update since publication review in 2009. Objectives To assess effectiveness antiviral agents preventing PHN. Search methods On 26 April 2013, we updated searches Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, Chinese Biomedical Retrieval System. We checked the references of published studies identify additional trials, contacted authors obtain data. searched other databases The Library information Discussion two clinical trials registries ongoing trials. Selection criteria We considered all randomised controlled (RCTs) treatment given within 72 hours after onset zoster There were no language restrictions. Data collection analysis Two independently selected evaluated risk bias included extracted analysed data. Main results Six RCTs total 1211 participants eligible; five oral aciclovir, one, 419 participants, famciclovir. able conduct meta-analyses there sufficient similarities studies, such reporting presence PHN, duration rash before initiation regimen. For our primary outcome, based on three (609 participants) found significant difference between aciclovir control groups incidence PHN four months acute herpetic (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.51 1.11), nor was six (RR 1.05, CI 0.87 1.27, 476 participants). In (692 participants), some evidence reduction pain weeks rash. trial famciclovir versus placebo, neither 500 mg 750 doses reduced significantly. most commonly reported adverse events nausea, vomiting, diarrhoea headache nausea significantly different from placebo. None high bias, although unclear least one domain but study. new when 2013. Authors' conclusions There quality that does not reduce addition, insufficient determine effect treatments; therefore, further well-designed needed investigate Future should pay more attention severity life be conducted among subgroups people, who immunocompromised.