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Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study.

Publication ,  Journal Article
Drolet, M; Brisson, M; Schmader, K; Levin, M; Johnson, R; Oxman, M; Patrick, D; Camden, S; Mansi, JA
Published in: J Pain
November 2010

UNLABELLED: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The main objectives of this study were to: 1) estimate the severity and duration of PHN; and 2) identify the predictors of PHN. From October, 2005 to July, 2006, 261 outpatients with HZ, aged ≥ 50, were recruited within 14 days of rash onset during the routine clinical practice of 83 physicians across Canada. Physicians documented HZ characteristics, treatments, general health, functional, and immune status. HZ pain was measured at recruitment and on days 7, 14, 21, 30, 60, 90, 120, 150, and 180 following recruitment. PHN was defined as a worst pain ≥ 3 persisting or appearing more than 90 days after rash onset. Predictors of PHN were obtained by hierarchical log-binomial regression. Twenty-two percent of 249 immunocompetent subjects with HZ developed PHN. Median duration of PHN was 77 days. Independent predictors of PHN included: older age, limitation in performing usual activities prior to HZ, and pain severity at recruitment. This study confirms that older age and greater acute pain severity are predictors of PHN, while functional status emerges as a novel independent predictor of PHN that deserves further exploration. These findings will contribute to optimal use of the HZ vaccine and testing of new therapies that might prevent PHN. PERSPECTIVE: This study confirmed that older age and greater acute pain severity are robust predictors of PHN, whereas functional status emerged as a novel predictor. Despite the high proportion of subjects treated with antivirals, the burden of PHN remains considerable, suggesting that prevention and additional early interventions are needed to reduce the burden of HZ.

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Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

November 2010

Volume

11

Issue

11

Start / End Page

1211 / 1221

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Prospective Studies
  • Predictive Value of Tests
  • Physical Examination
  • Pain Measurement
  • Neuralgia, Postherpetic
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

Citation

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Drolet, M., Brisson, M., Schmader, K., Levin, M., Johnson, R., Oxman, M., … Mansi, J. A. (2010). Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study. J Pain, 11(11), 1211–1221. https://doi.org/10.1016/j.jpain.2010.02.020
Drolet, Mélanie, Marc Brisson, Kenneth Schmader, Myron Levin, Robert Johnson, Michael Oxman, David Patrick, Stéphanie Camden, and James A. Mansi. “Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study.J Pain 11, no. 11 (November 2010): 1211–21. https://doi.org/10.1016/j.jpain.2010.02.020.
Drolet M, Brisson M, Schmader K, Levin M, Johnson R, Oxman M, et al. Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study. J Pain. 2010 Nov;11(11):1211–21.
Drolet, Mélanie, et al. “Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study.J Pain, vol. 11, no. 11, Nov. 2010, pp. 1211–21. Pubmed, doi:10.1016/j.jpain.2010.02.020.
Drolet M, Brisson M, Schmader K, Levin M, Johnson R, Oxman M, Patrick D, Camden S, Mansi JA. Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study. J Pain. 2010 Nov;11(11):1211–1221.
Journal cover image

Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

November 2010

Volume

11

Issue

11

Start / End Page

1211 / 1221

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Prospective Studies
  • Predictive Value of Tests
  • Physical Examination
  • Pain Measurement
  • Neuralgia, Postherpetic
  • Middle Aged
  • Male
  • Incidence
  • Humans