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Antiviral Regimen Promising for Post-Shingles Pain

Larger, placebo-controlled study is warranted

WEDNESDAY, May 10 (HealthDay News) -- Antiviral treatment with intravenous acyclovir followed by oral valacyclovir shows promise for treatment of post-herpetic neuralgia, according to the results of a prospective, open-label study published in the May 8 issue of the Archives of Neurology.

Dianna Quan, M.D., of the University of Colorado Health Sciences Center in Denver, and colleagues studied 15 patients with moderate to severe post-herpetic neuralgia. The patients received 10 mg/kg intravenous acyclovir every eight hours for 14 days. Subsequently, they received 1,000 mg oral valacyclovir three times daily for a month. Improvement was measured using patients' self-reported scores on a Numeric Rating Scale for Pain.

Pain scores for eight of the patients (53 percent) decreased by two or more points following the treatment. In addition, the treatment was well-tolerated by most patients, with all of the adverse effects from the intravenous acyclovir being mild and reversible.

"Because this was an open-label study with no placebo control, we cannot exclude the possibility that this effect was due to a placebo response or spontaneous improvement," the authors write. "However, based on our clinical experience in treating patients with post-herpetic neuralgia, a 53 percent success rate is promising." They add that "a large, randomized, double-blind, placebo-controlled trial is warranted" based on the results.

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