Postherpetic neuralgia and systemic corticosteroid therapy. Efficacy and safety

Corticosteroids are frequently advocated for use in prevention of postherpetic neuralgia (PHN), although their use is replete with controversy. The present study is a meta-analysis of the four well-controlled clinical studies conducted on this issue. The results indicated there is a statistically significant decrease in proportions affected at 6 and 12 weeks. Standard difference scores were -2.0559 and -4.1442, respectively, and 95% confidence intervals were -3.98% to -31.80% and -14.16% to -43.84%, respectively. At 24 weeks, no differences were detectable between placebo- and corticosteroid-treated groups (SD = 0.6603, p greater than 0.05, 95% confidence intervals of -6.78% to 24.67%). Side effects of treatment were rare and mild, affecting only 2.5% of patients treated with corticosteroids. No patients had dissemination of disease. Systemic corticosteroid treatment decreases the proportion of patients affected by PHN, especially when it is defined as pain occurring at 6 or 12 weeks after the acute event.