Prevention of postherpetic neuralgia with varicella-zoster hyperimmune globulin

Recovery after an acute attack of herpes zoster is followed by postherpetic neuralgia (PHN) in 9–14% of all patients. Depending on the patient's age, the severity of the acute attack of herpes zoster and the dermatome involved, the incidence of PHN may be as high as 65%. The purpose of our stud...

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Bibliographic Details
Published in:European journal of pain 2002-01, Vol.6 (6), p.435-445
Main Authors: Hügler, Peter, Siebrecht, Peter, Hoffmann, Klaus, Stücker, Markus, Windeler, Jürgen, Altmeyer, Peter, Laubenthal, Heinz
Format: Article
Language:English
Subjects:
Aged
double-blind placebo-controlled randomised investigation
Female
Herpes Zoster - complications
Herpes Zoster - drug therapy
Herpes Zoster - immunology
Humans
immune globulin
Immune Sera - administration & dosage
Male
Middle Aged
Neuralgia - drug therapy
Neuralgia - prevention & control
Neuralgia - virology
Pain Measurement - drug effects
postherpetic neuralgia
prophylaxis
Treatment Outcome
varicella-zoster virus
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Summary:Recovery after an acute attack of herpes zoster is followed by postherpetic neuralgia (PHN) in 9–14% of all patients. Depending on the patient's age, the severity of the acute attack of herpes zoster and the dermatome involved, the incidence of PHN may be as high as 65%. The purpose of our study was to ascertain the incidence of PHN after a prophylactic intravenous injection of varicella-zoster hyperimmune globulin (VZV-IG) (Varitect Biotest Pharma). For this double-blind placebo-controlled randomised investigation we defined PHN as pain confined to the dermatome previously affected by herpes zoster, and we required a pain intensity of at least 15% points on a visual analogue scale (VAS) for this dermatome. The inclusion criteria were the dermatological diagnosis of herpes zoster together with age over 50 years. On Day 1, 20 patients received a single intravenous infusion of VZV-IG in a dose of 2 mL/kg body weight, 20 patients (control group) received a single infusion of human albumin 5% in a dose of 2 mL/kg body weight. All patients received acyclovir intravenously in a dose of 15 mg/kg body weight per 24 h for 5 days. The patients were followed up for a total of 42 days. The incidence of PHN at Day 42 was selected as the main outcome criterion for assessing the efficacy of prophylaxis. On reaching a significant difference between the groups ( t test; α
ISSN:1090-3801
1532-2149
DOI:10.1016/S1090-3801(02)00046-0