&lt;p&gt;Patient and economic burdens of postherpetic neuralgia in China&lt;/p&gt;

Yu, Shengyuan; Fan, Bifa; Yang, Fei; DiBonaventura, Marco; Chen, Yuxuan; Li, Ruoyu; King-Concialdi, Kristen; Kudel, Ian; Hlavacek, Patrick; Hopps, Markay; Udall, Margarita; Sadosky, Alesia; Cappelleri, Joseph C.

doi:10.2147/ceor.s203920

Cited by 26 publications

(30 citation statements)

References 46 publications

(55 reference statements)

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“… 1 PHN is the most common complication of shingles, with an incidence of 5% to 30% in patients with herpes zoster. 2 It is a persistent, debilitating, and chronic pain condition that is characterized by spontaneous pain, hyperalgesia, allodynia, and paresthesia in the dermatomal areas where shingles was present. Patients consider these troublesome syndromes to be intolerable, and they interfere the sleep and cause depression, thereby decreasing a patient’s quality of life and leading to functional impairment and lost productivity.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

et al. 2020

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Objective We aimed to perform a network meta-analysis that combined both direct and indirect evidence to compare the relative efficacy of interventional therapies to treat patients with postherpetic neuralgia (PHN) and to determine the treatments’ superiority and validity. Method A conventional paired meta-analysis was performed. This was followed by a network meta-analysis using the Bayesian framework. Results Botulinum toxin type A and pulsed radiofrequency (PRF) were the two most effective individual interventions. For combination therapy, PRF + nerve block (NB) was the best choice, followed by subcutaneous injection or local infiltration (SC) + NB + ozone (O3). However, the combination of PRF + NB + SC showed reduced the efficacy compared with each treatment and was highly invasive for patients. After a long-term follow-up, PRF was shown to be the most effective therapy for treating patients with PHN. Conclusions Regular anti-neuropathic drug administration that was accompanied by interventional therapies at an early stage is the best choice to treat patients with PHN. Appropriate combinations of different interventions show improved pain relief. Clinicians should manage therapeutic regimens on the basis of the patients specific condition and existing measures and strive to achieve personalized treatment.

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Section: Introductionmentioning

confidence: 99%

“… 3 PHN causes an increase in the use of health care resources and an increased economic burden on society. 2 , 4 …”

Section: Introductionmentioning

confidence: 99%

Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

et al. 2020

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“…The study found total direct medical costs of ¥10,600. The costs were driven by higher hospitalization costs of ¥9300 compared to our study, which was driven mostly by higher drug costs [16]. The societal costs of patients with rheumatoid arthritis across 21 tertiary care hospitals between July 2009 and December 2010 were studied [17].…”

Section: Discussionmentioning

confidence: 66%

“…Resource utilization included physician visits of 9.33 per year and 0.23 hospital days per year (physician survey). The cost per physician visit (¥298.72) and hospital day (¥841.90) was sourced from a recent burden of illness study for postherpetic neuralgia in China [16]. A cost per year for lab tests (¥508.33) and radiologic tests (¥808.33) was also applied to patients.…”

Section: Model Inputsmentioning

confidence: 99%

Using a Physician Survey to Estimate the Economic Burden of Fibromyalgia in China

Furnback¹,

Chen²,

Li³

et al. 2020

Preprint

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Background: Fibromyalgia (FM) is a chronic pain disorder with a global prevalence estimated to be between 2 and 3%. In addition to the chronic pain incurred by patients, FM is commonly associated with comorbidities and complications such as depression, anxiety, and sleep disturbances. This study estimates the economic burden of patients with FM in China using a physician survey. Methods: A burden of illness model was constructed using a micro-costing approach to estimate the direct cost associated with FM patients in China. FM-related comorbidities of anxiety, depression, and sleep disturbance were included in the model. Treatment utilization and costs for FM and FM-related comorbidities were included as well as FM-related healthcare resource utilization (physician visits, hospitalizations, blood tests, and radiologic tests). FM treatments included nonsteroidal anti-inflammatory drugs, pregabalin, duloxetine, amitriptyline, tramadol, Chinese medicine, physiotherapy, and acupuncture. The model leveraged the results of a physician survey, which targeted 6 rheumatologists and pain experts each with 5-10 FM patients per month in China. All costs are presented in Renminbi (¥) using spot exchange rates as of May 1, 2020.Results: From the physician survey, the prevalence rate of FM in China was estimated to be 2.8% with 75.8% as female. The economic model estimated the annual per patient direct medical cost of FM to be ¥17,377. Within these costs, FM-medication and treatment costs (¥11,216), healthcare resource utilization (¥4,297), and costs for medications treating FM-related comorbidities (¥1,863) were the highest contributors. Healthcare resource utilization costs were driven by physician visits (¥2,787) followed by radiographic tests (¥808), blood tests (¥508), and hospitalizations (¥194). Conclusion: The prevalence and gender distribution of FM patients in China is similar to those of other countries. The economic model estimates patients with fibromyalgia in China to incur significant economic costs.

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“…Among those cases, 30% [2] are predicted to develop PHN after 12 weeks. Recent investigation [4] has shown that PHN is associated with sleep disturbances, lower quality of life, restricted daily activities and increased medical costs, all of which impose heavy burden on the patient and their finances. In addition, neuropathic pain [5] often persists for months or years and is refractory to drugs.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Effect of duloxetine premedication for postherpetic neuralgia within 72 h of herpes zoster reactivation [PROCESS]: a study protocol for a randomized controlled trial

Chen

Shrestha

Zhao

et al. 2020

Trials

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Background Postherpetic neuralgia (PHN) is the most common complication attributed to herpes zoster, which involves the reactivation of residual varicella zoster virus. It has been reported previously that pre-emptive amitriptyline following acute herpes zoster has shown latent positive effects in the prevention of PHN. In this study, by interfering with the same targets, norepinephrine and serotonin, we aim to evaluate whether pre-emptive duloxetine may proactively prevent PHN development. Methods This is a nationwide multicentric, randomized, open-label, blinded-endpoint study that will recruit 750 participants from 18 primary centres in China. Patients aged more than 50 years who are diagnosed with uncomplicated HZ, present with vesicles within 72 h of their emergence, and have an average pain score of at least 40/100 mm on a visual analogue scale (VAS, 0 mm = no pain, 100 mm = worst possible pain, at opposite ends of a 100-mm line) will be recruited for this study. Participants will be randomized into a duloxetine arm and a control arm. Participants allocated to the duloxetine arm will be given antivirals, analgesics and duloxetine, while those allocated to the control arm will receive antivirals and analgesics but no duloxetine. The primary outcome of this study is preventive efficacy against PHN, which will be evaluated based on a 100 mm VAS. Any pain scores other than 0 mm on the VAS 12 weeks after HZ onset will be defined as PHN. The secondary outcomes will consist of the average weekly VAS score, the average weekly consumption of each analgesic, weekly feature of the pain, patients’ quality of life based on the 12-item Short-Form Health Survey, Patient Global Impression of Change Scale, sleep quality as evaluated by the Pittsburgh Sleep Quality Index and adverse events during the study period. Discussion This study will investigate a prophylactic approach for reducing the prevalence of postherpetic neuralgia with duloxetine and will add significant new knowledge on the preventive effects of duloxetine on PHN. Trial registration Clinicaltrials.gov NCT04313335. Registered on 18 March 2020.

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<p>Patient and economic burdens of postherpetic neuralgia in China</p>

Cited by 26 publications

References 46 publications

Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

Using a Physician Survey to Estimate the Economic Burden of Fibromyalgia in China

Effect of duloxetine premedication for postherpetic neuralgia within 72 h of herpes zoster reactivation [PROCESS]: a study protocol for a randomized controlled trial

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