Treatment and Prevention of Shingles - Combination of Viral Drugs May Treat Shin
Researchers say that a combination of antiviral drug medications will reduce nerve pain following a shingles infection. The study, led by Dianna Quan, MD and her colleagues at the University of Colorado and Health Sciences Center, Denver, administered the antiviral therapy to 15 patients (12 men and three women).
The participants received 10 milligrams of the medication acyclovir intravenously every eight hours for 14 days and then took three 1,000-milligram pills of the medication valacyclovir every day for one month. The patients were asked to rate their pain from a scale of zero to 10, both before and after the treatment, and than again a month after finishing the valacyclovir therapy.
The results were hopeful. One month after the therapy, eight (or 53 percent) patients reported that their pain had reduced significantly (by two or more points). This is about the same as those who reported such an improvement after day 15 (seven) and after day 45 (eight).
Although most patients tolerated the treatment well, there were five who dropped out of the study early. Three of these patients dropped out due to complications related to the therapy.
The research, which will appear in the July 2006 print issue of Archives of Neurology, one of the JAMA/Archives journals, is considered a small study. The researchers said "Although our study was small and without placebo control, the findings suggest a promising effect of antiviral treatment on postherpetic neuralgia. Treatment of postherpetic neuralgia with IV acyclovir will be expensive. However, elimination or reduction of pain coupled with reduced burden of disease and use of health care resources would offset treatment costs."
Shingles (herpes zoster) is caused by the varicella-zoster virus. This is the same virus that causes chickenpox, according to background information in the article. The virus will remain dormant in the nervous system for decades after infection with chickenpox. When the virus becomes reactivated, it causes a rash and nerve pain called postherpetic neuralgia. Postherpetic neuralgia can last for months or years and affects as many as one million people in the United States.
The Food and Drug Administration (FDA) has just approved a drug produced by Merck, Zostavax, for the prevention of shingles in individuals 60 years of age and older. This is the first and only medical option approved for preventing shingles.
About 90 percent of all adults in the US have been infected with chickenpox. The drug could reduce the incidence and severity of shingles infections.
The disease usually starts as an unusual or painful sensation on one side of the body or face, followed by a blistering rash. The problem is that shingles can cause long term never pain. The pain has been described as tender, burning, throbbing, stabbing, shooting and/or sharp pain. Even the touch of soft clothing can cause pain. Other complications include hearing loss, pneumonia, visual impairment, and scaring.
Zostavax is not a treatment for shingles, but only a preventative measure. It is hoped that the dual antiviral treatment can relieve the nerve pain associated with shingles.
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