Herpes zoster pain including shingles and postherpetic neuralgia

2008 ◽  
pp. 429-439
Author(s):  
Robert W Johnson
Keyword(s):  
Herpes Zoster ◽  
Postherpetic Neuralgia

scholarly journals Recombinant Zoster Vaccine (Shingrix) real-world effectiveness in the first two years post-licensure

2021 ◽  
Author(s):  
Hector S Izurieta ◽  
Xiyuan Wu ◽  
Richard Forshee ◽  
Yun Lu ◽  
Heng-Ming Sung ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Herpes Zoster ◽  
Real World ◽  
Postherpetic Neuralgia ◽  
Vaccine Effectiveness ◽  
Community Dwelling ◽  
Zoster Vaccine ◽  
Post Market ◽  
Recombinant Zoster Vaccine ◽  
Dose Vaccine

Abstract Background Shingrix™ (recombinant zoster vaccine) was licensed to prevent herpes zoster, dispensed as two doses given 2–6 months apart, among adults ages ≥50 years. Clinical trials yielded efficacy of >90% for confirmed herpes zoster,but post-market vaccine performance has not been evaluated. Efficacy of a single dose, delayed second dose, or among persons with autoimmune or general immunosuppressive conditions have also not been studied. We aimed to assess post-market vaccine effectiveness of Shingrix. Methods We conducted a cohort study among vaccinated and unvaccinated Medicare Part D community dwelling beneficiaries ages >65 years. Herpes zoster was identified using a medical office visit diagnosis with treatment, and postherpetic neuralgia using a validated algorithm. We used inverse probability of treatment weighting to improve cohort balance, and marginal structural models to estimate hazard ratios. Results We found a vaccine effectiveness of 70.1% (95% CI, 68.6–71.5) and 56.9% (95% CI, 55.0–58.8) for two and one doses, respectively. The two-dose vaccine effectiveness was not significantly lower for beneficiaries 80+ years, for second doses received at ≥180 days, or for individuals with autoimmune conditions. The vaccine was also effective among individuals with immunosuppressive conditions. Two-dose vaccine effectiveness against postherpetic neuralgia was 76.0% (95% CI, 68.4-81.8). Conclusions This large real-world observational study of effectiveness of Shingrix demonstrates the benefit of completing the two-dose regimen. Second doses administered beyond the recommended 6 months did not impair vaccine effectiveness.Our effectiveness estimates were lower than the clinical trials estimates, likely due to differences in outcome specificity.

Predictors of Postherpetic Neuralgia Among Patients With Herpes Zoster: A Prospective Study

2010 ◽  
Vol 11 (11) ◽  
pp. 1211-1221 ◽  
Author(s):  
Mélanie Drolet ◽  
Marc Brisson ◽  
Kenneth Schmader ◽  
Myron Levin ◽  
Robert Johnson ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Prospective Study ◽  
Postherpetic Neuralgia ◽  
A Prospective Study

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

2016 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Clinical Manifestations ◽  
The United States ◽  
Evidence Based ◽  
Pain Medicine ◽  
High Prevalence ◽  
Antiviral Medications ◽  
Physician’S Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. This review contains 6 figures, 4 tables and 13 references Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

Is herpes zoster vaccine safe and effective for preventing zoster and postherpetic neuralgia?

2015 ◽  
Vol 18 (9) ◽  
pp. 9-10
Author(s):  
Emily Colson ◽  
Aaron TenHarmsel ◽  
Michael D. Geurin
Keyword(s):  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Zoster Vaccine

Reduction of Postherpetic Neuralgia in Herpes Zoster

2001 ◽  
Vol 5 (5) ◽  
pp. 409-416 ◽  
Author(s):  
Melody Vander Straten ◽  
Daniel Carrasco ◽  
Patricia Lee ◽  
Stephen K. Tyring
Keyword(s):  
Herpes Zoster ◽  
Elderly Patients ◽  
Antiviral Therapy ◽  
Postherpetic Neuralgia ◽  
Varicella Vaccine ◽  
Distant Future ◽  
Increased Risk ◽  
Antiviral Medication

Background: Persons 50 years of age and older are not only at increased risk of developing herpes zoster, they are also more likely to suffer the long-term morbidity of postherpetic neuralgia (PHN). PHN is pain persisting after the rash of herpes zoster has healed. PHN affects at least 40% of all herpes zoster patients over age 50 and over 75% of herpes zoster patients over age 75; PHN is the single most common neurologic condition in elderly patients. Objective: The objective of this review is to evaluate interventions that may reduce or even eliminate PHN. No single therapy has been consistently effective for PHN. The most effective approach appears to be with the use of antiviral therapy early in the course of herpes zoster. The goals of ongoing studies in herpes zoster are to develop interventions that will further reduce the symptoms of PHN and/or to eliminate PHN by prophylaxis using the varicella vaccine. Conclusions: Reduction of PHN can best be achieved with the use of antiviral medication early in the course of herpes zoster; other classes of drugs are minimally effective in treating established PHN. Widespread use of the varicella vaccine may lead to secondary reductions in PHN in the distant future.

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