Postherpetic Neuralgia and Systemic Corticosteroid Therapy

Abstract

Corticosteroids are frequently advocated for use in prevention of postherpetic neuralgia (PHN), although their use is replete with controversy. The present study is a meta-analysis of the four well-controlled clinical studies conducted on this issue. The results indicated there is a statistically significant decrease in proportions affected at 6 and 12 weeks. Standard difference scores were -2.0559 and -4.1442, respectively, and 95% confidence intervals were -3.98% to -31.80% and -14.16% to -43.84%, respectively. At 24 weeks, no differences were detectable between placebo- and corticosteroid-treated groups (SD = 0.6603, p greater than 0.05, 95% confidence intervals of -6.78% to 24.67%). Side effects of treatment were rare and mild, affecting only 2.5% of patients treated with corticosteroids. No patients had dissemination of disease. Systemic corticosteroid treatment decreases the proportion of patients affected by PHN, especially when it is defined as pain occurring at 6 or 12 weeks after the acute event.