Iontophoretic Vincristine in the Treatment of Postherpetic Neuralgia

Dowd, N.; Day, Fergal; Timon, Deirdre; Cunningham, Anthony J.; Brown, Lorna

doi:10.1016/s0885-3924(98)00121-3

Cited by 14 publications

(5 citation statements)

References 17 publications

(16 reference statements)

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“…Ninety‐four studies were included in the pain intensity analysis, with a total of 5,317 subjects [13–106]. The mean (SD) baseline pain intensity was 6.3 (1.0).…”

Section: Resultsmentioning

confidence: 99%

Placebo Response Changes Depending on the Neuropathic Pain Syndrome: Results of a Systematic Review and Meta-Analysis

Cepeda

Berlin

Gao³

et al. 2012

Pain Med

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“…Ninety‐four studies were included in the pain intensity analysis, with a total of 5,317 subjects [13–106]. The mean (SD) baseline pain intensity was 6.3 (1.0).…”

Section: Resultsmentioning

confidence: 99%

Placebo Response Changes Depending on the Neuropathic Pain Syndrome: Results of a Systematic Review and Meta-Analysis

Cepeda

Berlin

Gao³

et al. 2012

Pain Med

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“…Transdermal iontophoresis of 0.01% (20 ml) vincristine showed no benefit for pain relief in a parallel group study (20 patient episodes) [52]. …”

Section: Resultsmentioning

confidence: 99%

Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review

et al. 2005

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BackgroundPostherpetic neuralgia (PHN) is a complication of acute herpes zoster, which is emerging as a preferred clinical trial model for chronic neuropathic pain. Although there are published meta-analyses of analgesic therapy in PHN, and neuropathic pain in general, the evidence base has been substantially enhanced by the recent publication of several major trials. Therefore, we have conducted a systematic review and meta-analysis for both efficacy and adverse events of analgesic therapy for PHN.Methods and FindingsWe systematically searched databases (MEDLINE 1966–2004, EMBASE 1988–2004, CINAHL 1982–2002, and PubMed [29 October 2004]) for trials of PHN. We also searched references of retrieved studies and review articles for further trials. We included trials that examined adult patients with PHN of greater duration than 3 mo, that were blinded, randomised, and had at least one measure of pain outcome. Dichotomous pain outcome data were extracted for 50% decrease in baseline pain using a hierarchy of pain/pain-relief measurement tools. Where available, dichotomous data were also collected for adverse events. Calculated estimates of efficacy included relative benefit and number needed to treat.Of 62 studies identified, 35 were randomised controlled trials. Of these, 31 were placebo controlled and suitable for meta-analysis, from which it was possible to extract dichotomous efficacy outcome data from 25.This meta-analysis revealed that there is evidence to support the use of the following orally administered therapies: tricyclic antidepressants, “strong” opioids, gabapentin, tramadol, and pregabalin. Topical therapies associated with efficacy were lidocaine 5% patch and capsaicin. Finally, a single study of spinal intrathecal administration of lidocaine and methyl prednisolone demonstrated efficacy, although this has yet to be replicated.Data suggest that the following therapies are not associated with efficacy in PHN: certain NMDA receptor antagonists (e.g., oral memantine, oral dextromethorphan, intravenous ketamine), codeine, ibuprofen, lorazepam, certain 5HT1 receptor agonists, and acyclovir. Topical administration of benzydamine, diclofenac/diethyl ether, and vincristine (iontophoresis) are similarly not associated with efficacy, nor are intrathecal administration of lidocaine alone or epidural administration of lidocaine and methylprednisolone, intravenous therapy with lidocaine, subcutaneous injection of Cronassial, or acupuncture. However, many of the trials that demonstrated a lack of efficacy represented comparatively low numbers of patient episodes or were single-dose studies, so it may be appropriate to regard such interventions as “not yet adequately tested” rather than demonstrating “no evidence of efficacy.” Topical aspirin/diethyl ether has not been adequately tested.ConclusionThe evidence base supports the oral use of tricyclic antidepressants, certain opioids, and gabapentinoids in PHN. Topical therapy with lidocaine patches and capsaicin is similarly supported. Intrathecal administration of m...

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“…Some clinical advantage was observed (40), however, the extent of this benefit, and its safety, is still unclear. In additon, there is lack of evidence for the benefit of vincristine in the treatment of post‐herpetic neuralgia (95).…”

Section: Management Of Post‐herpetic Neuralgiamentioning

confidence: 99%

Varicella zoster virus: review of its management

Mustafa

Arduino

Porter

2009

J Oral Pathology Medicine

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Varicella zoster virus (VZV) is one of eight herpes viruses known to infect humans. Primary infection causes varicella (chickenpox), after which virus becomes latent. Years later, VZV reactivates and causes a wide range of neurological diseases. The aim of the present report was to critically examine the published literature to evaluate advantages and limitations of therapy of VZV infection in both immunocompetent and immunocompromised patients. Aciclovir (ACV) has been the drug of choice for many years for the treatment of VZV infections. Recently, other antiviral agents have been developed to overcome the low oral bioavailability of ACV, as well as to provide a more flattering dosage regime. Chickenpox is a benign self-limiting disease in the majority of cases and usually no specific treatment is required. Treatment of shingles is indicated to reduce the acute symptoms of pain and malaise, to limit the spread and duration of the skin lesions and to prevent the development of post-herpetic neuralgia. Different classes of drugs have been used for the treatment of post-herpetic neuralgia. The first choice of any of these medications should be guided by the patient's medical health, the likely adverse effects of the drug and the patient's preference.

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Iontophoretic Vincristine in the Treatment of Postherpetic Neuralgia

Cited by 14 publications

References 17 publications

Placebo Response Changes Depending on the Neuropathic Pain Syndrome: Results of a Systematic Review and Meta-Analysis

Placebo Response Changes Depending on the Neuropathic Pain Syndrome: Results of a Systematic Review and Meta-Analysis

Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review

Varicella zoster virus: review of its management

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