ASSESSMENT OF PAIN IN HERPES-ZOSTER - LESSONS LEARNED FROM ANTIVIRAL TRIALS

Pain typically accompanies acute herpes tester and, in a proportion of patients, it persists well beyond rash healing. Pain must therefore b e analyzed in trials of antiviral agents in herpes tester, but differe nt methods have been used to analyze pain in recent published trials. These reports are reviewed and their methodological strengths and weak nesses examined. Based on this review? recommendations for the design and analysis of future trials of antiviral agents in herpes tester are proposed. The principal recommendation is that antiviral efficacy sho uld be evaluated both by distinguishing post-herpetic neuralgia from a cute pain and by considering pain as a continuum. The primary endpoint should address both the prevalence and duration of post-herpetic neur algia and should be examined in those patients who have post-herpetic neuralgia. Adopting the proposed recommendations in design and analysi s of future trials should facilitate comparison across trials of the e fficacy of antiviral agents in the treatment of herpes tester. Copyrig ht (C) 1997 Elsevier Science B.V.