title: Assessment of pain in herpes zoster: lessons learned from antiviral trials.
abstract: Pain typically accompanies acute herpes zoster and, in a proportion of patients, it persists well beyond rash healing. Pain must therefore be analyzed in trials of antiviral agents in herpes zoster, but different methods have been used to analyze pain in recent published trials. These reports are reviewed and their methodological strengths and weaknesses examined. Based on this review, recommendations for the design and analysis of future trials of antiviral agents in herpes zoster are proposed. The principal recommendation is that antiviral efficacy should be evaluated both by distinguishing post-herpetic neuralgia from acute pain and by considering pain as a continuum. The primary endpoint should address both the prevalence and duration of post-herpetic neuralgia and should be examined in those patients who have post-herpetic neuralgia. Adopting the proposed recommendations in design and analysis of future trials should facilitate comparison across trials of the efficacy of antiviral agents in the treatment of herpes zoster.
authors.affiliation: Columbia-Presbyterian Medical Center, New York, NY, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Dworkin
authors.forename: D
authors.initials: D
authors.lastname: Carrington
authors.forename: A
authors.initials: A
authors.lastname: Cunningham
authors.forename: R G
authors.initials: RG
authors.lastname: Kost
authors.forename: M J
authors.initials: MJ
authors.lastname: Levin
authors.forename: M W
authors.initials: MW
authors.lastname: McKendrick
authors.forename: M N
authors.initials: MN
authors.lastname: Oxman
authors.forename: B
authors.initials: B
authors.lastname: Rentier
authors.forename: K E
authors.initials: KE
authors.lastname: Schmader
authors.forename: G
authors.initials: G
authors.lastname: Tappeiner
authors.forename: S W
authors.initials: SW
authors.lastname: Wassilew
authors.forename: R J
authors.initials: RJ
authors.lastname: Whitley
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005544:Forecasting; D006562:Herpes Zoster / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D010147:Pain Measurement; D012107:Research Design
chemical_list: D000998:Antiviral Agents