Efficacy of Piroxicam Patch Compared to Lidocaine Patch for the Treatment of Postherpetic Neuralgia

BackgroundIn spite of the large body of evidence available in the literature, definition and treatment of Post-Herpetic Neuralgia (PHN) are still lacking a consistent and universally recognized standardization. Furthermore, many issues concerning diagnosis, prediction and prevention of PHN need to be clarified in view of recent contributions.ObjectivesTo assess whether PHN may be better defined, predicted, treated and prevented in light of recent data, and whether available alternative or adjunctive therapies may improve pain relief in treatment recalcitrant PHN.MethodsSystematic reviews, meta-analyses, randomized controlled trials, cohort studies and protocols were searched; the search sources included PubMed, Cochrane Library, NICE, and DARE. More than 130 papers were selected and evaluated.ResultsDiagnosis of PHN is essentially clinical, but it can be improved by resorting to the many tools available, including some practical and accessible questionnaires. Prediction of PHN can be now much more accurate, taking into consideration a few well validated clinical and anamnestic variables. Treatment of PHN is presently based on a well characterized array of drugs and drug associations, including, among others, tricyclic antidepressants, gabapentinoids, opioids and many topical formulations. It is still unsatisfactory, however, in a substantial proportion of patients, especially those with many comorbidities and intense pain at herpes zoster (HZ) presentation, so that this frequent complication of HZ still strongly impacts on the quality of life of affected patients.ConclusionFurther efforts are needed to improve the management of PHN. Potentially relevant interventions may include early antiviral therapy of acute HZ, prevention of HZ by adult vaccination, as well as new therapeutic approaches for patients experiencing PHN.

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“…A recent trial evaluated the efficacy of piroxicam patches, resulting in faster and better effects. 103 …”

Section: Resultsmentioning

confidence: 99%

Post-herpetic neuralgia

Parruti¹,

Tontodonati²,

Ursini³

et al. 2012

IJGM

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“…The 5 % lidocaine patch and 5 % lidocaine-medicated plaster are safe and appear to be effective and well-tolerated by patients with PHN and allodynia. 13,[40][41][42][43][44][45][46] Patients with a small focal area of well-localised NP may benefit from topical lidocaine the most. 47 Since the drug is not absorbed systemically, there are no systemic adverse effects.…”

Section: Topical Lidocainementioning

confidence: 99%

Management of Neuropathic Pain - Current Insights and Future Perspectives

Smith

Kara²,

Argoff³

2012

European Neurological Review

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The management of neuropathic pain remains very challenging and very much an art. Despite the publication of multiple consensus guidelines on the management of neuropathic pain, a significant subpopulation of patients with neuropathic pain are not afforded adequate relief, employing various treatment algorithms with conventional pharmacological therapeutic strategies. First-line agents for the treatment of neuropathic pain include: tricyclic antidepressants, selective serotonin/norepinephrine re-uptake inhibitors, calcium channel 〈2-δ ligands and, in certain cases of focal neuropathic pain, a lidocaine patch. Novel analgesics under development may include: purinergic receptor modulators, cannabinoid receptor modulators, neurokinin-1 (NK-1) receptor modulators, glial modulators, rostral ventral medulla ‘on-cell’ modulators, chemokine receptor modulators, toll-like receptor modulators, modulators of tetrahydrobiopterin synthesis and/or chemically re-engineered conotoxins. It is hoped that future agents and/or combinations of agents may be helpful to this refractory subpopulation.

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“…The 5 % lidocaine patch and 5 % lidocaine-medicated plaster are safe and appear to be effective and well-tolerated by patients with PHN and allodynia. 13,[40][41][42][43][44][45][46] Patients with a small focal area of well-localized NP may benefit from topical lidocaine the most. 47 Since the drug is not absorbed systemically, there are no systemic adverse effects.…”

Section: Topical Lidocainementioning

confidence: 99%

Management of Neuropathic Pain—Current Insights and Future Perspectives

Smith¹,

Kara²,

Argoff³

2012

US Neurology

View full text Add to dashboard Cite

The management of neuropathic pain remains very challenging and very much an art. Despite the publication of multiple consensus guidelines on the management of neuropathic pain, a significant subpopulation of patients with neuropathic pain are not afforded adequate relief, employing various treatment algorithms with conventional pharmacologic therapeutic strategies. First-line agents for the treatment of neuropathic pain include: tricyclic antidepressants, selective serotonin/norepinephrine re-uptake inhibitors, calcium channel α2-δ ligands and, in certain cases of focal neuropathic pain, a lidocaine patch. Novel analgesics under development may include: purinergic receptor modulators, cannabinoid receptor modulators, neurokinin-1 (NK-1) receptor modulators, glial modulators, rostral ventral medulla ‘on-cell’ modulators, chemokine receptor modulators, toll-like receptor modulators, modulators of tetrahydrobiopterin synthesis, and/or chemically re-engineered conotoxins. It is hoped that future agents and/or combinations of agents may be helpful to this refractory subpopulation.

show abstract

Efficacy of Piroxicam Patch Compared to Lidocaine Patch for the Treatment of Postherpetic Neuralgia

Cited by 8 publications

References 27 publications

Post-herpetic neuralgia

Post-herpetic neuralgia

Management of Neuropathic Pain - Current Insights and Future Perspectives

Management of Neuropathic Pain—Current Insights and Future Perspectives

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