Antiviral Drugs May Help Relieve Nerve Pain Related to Shingles
A small trial suggests that treatment with intravenous and oral
antiviral medications may reduce the nerve pain that occurs following
shingles, according
to a study posted online that will appear in the July 2006 print
issue of Archives of Neurology, one of the JAMA/Archives journals.
Shingles (herpes zoster) is caused by the varicella-zoster virus,
the same virus that causes chickenpox, according to background information
in the article. The virus lays dormant in the nervous system for
decades after infection with chickenpox. When it becomes reactivated, the
virus causes a
rash and nerve pain (postherpetic neuralgia). Postherpetic neuralgia
can that lasts for months or years and affects as many as one million people
in the
United States.
Dianna Quan, MD, and colleagues at the University of Colorado Denver, administered antiviral therapy
to 15 patients (12 men and three women) with moderate to severe nerve pain
following shingles.
Participants received 10 milligrams of the medication acyclovir intravenously
every eight hours for 14 days and then took three 1,000-milligram
pills of the medication valacyclovir per day for one month. The patients were
asked
to rate their pain on a scale of zero to 10 at the beginning of the
study, then again after finishing each therapy and one month after finishing
valacyclovir.
One month after therapy, eight (53 percent) patients reported that
their pain had reduced significantly (by two or more points). This
was similar to the percentage of patients who reported such an improvement
after day 15
(seven) and after day 45 (eight). Most patients tolerated the treatment
well, although five dropped out of the study early, three of them because
of complications
related to the therapy.
“
Although our study was small and without placebo control, the findings
suggest a promising effect of antiviral treatment on postherpetic neuralgia,” the
authors conclude.
“ Treatment of postherpetic neuralgia with IV acyclovir
will be expensive. However, elimination or reduction of pain coupled
with reduced burden of disease and use of health care resources would offset
treatment
costs.”
This study was supported in part by grants from the National Institutes
of Health and a grant from the Avenir Foundation.
