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Corticosteroids for preventing postherpetic neuralgia.

Ning Chen1, Mi Yang, Li He

  • 1Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, China, 610041.

The Cochrane Database of Systematic Reviews
|December 15, 2010
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Summary

Corticosteroids administered during acute herpes zoster infection do not prevent postherpetic neuralgia. Studies found no significant difference in adverse events between corticosteroid and placebo groups.

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Pharmacology

Background:

  • Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster (shingles).
  • Corticosteroids possess anti-inflammatory properties, prompting investigation into their potential prophylactic role against PHN.

Purpose of the Study:

  • To systematically evaluate the efficacy of corticosteroids in preventing the development of postherpetic neuralgia following acute herpes zoster infection.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (MEDLINE, EMBASE, LILACS, CENTRAL) for randomized controlled trials (RCTs).
  • RCTs involving oral, intramuscular, or intravenous corticosteroids administered within seven days of herpes zoster onset were included.
  • Data extraction and quality assessment were performed independently by two authors, with disagreements resolved by consensus.

Main Results:

  • Five RCTs with 787 participants were included in the meta-analysis.
  • Oral corticosteroids did not significantly prevent postherpetic neuralgia six months post-herpes onset (RR, 0.95; 95% CI 0.45 to 1.99).
  • No significant differences in serious or non-serious adverse events were observed between corticosteroid and placebo groups.

Conclusions:

  • Acutely administered corticosteroids are ineffective in preventing postherpetic neuralgia.
  • The risks associated with acute corticosteroid administration in herpes zoster appear minimal.
  • Future research should incorporate long-term follow-up and quality-of-life measures to fully assess corticosteroid effects on PHN development.