Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open-label, randomized trial in the VZV pain study

Background Data on the potential efficacy of acupuncture (AC) in controlling intense or very intense pain in patients with Herpes Zoster (HZ) has not been so far adequately assessed in comparison with standard pharmacological treatment (ST) by a controlled trial design. Methods Within the VZV Pescar...

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Published in:Deutsche Zeitschrift für Akupunktur (Heidelberg, Germany : 1977) Germany : 1977), 2012-01, Vol.55 (2), p.26-27
Main Authors: Ursini, T., Tontodonati, M., Manzoli, L., Polilli, E., Rebuzzi, C., Congedo, G., Di Profio, S., Toro, P. M., Consorte, A., Placido, G., Laganà, S., D’Amario, C., Granchelli, C., Parruti, G., Pippa, L., Bäumler, Petra
Format: Article
Language:eng ; ger
Subjects:
Acupuncture
Complementary & Alternative Medicine
Herpes viruses
Journal Club
Medicine
Medicine & Public Health
Pain
Pain Medicine
Response rates
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Summary:Background Data on the potential efficacy of acupuncture (AC) in controlling intense or very intense pain in patients with Herpes Zoster (HZ) has not been so far adequately assessed in comparison with standard pharmacological treatment (ST) by a controlled trial design. Methods Within the VZV Pescara study, pain was assessed in HZ patients on a Visual Analogue Scale (VAS) and by the McGill Pain Questionnaire (MPQ) both at the beginning and at the end of treatment. Response rates, mean changes in pain intensity, differences in total pain burden with an area-under-the-curve (AUC) method over a 1-year follow-up and differences in the incidence of Post-Herpetic Neuralgia (PHN) were evaluated. Results One hundred and two patients were randomized to receive either AC (n = 52) or ST (n = 50) for 4 weeks. Groups were comparable regarding age, sex, pain intensity at presentation and missed antiviral prescription. Both interventions were largely effective. No significant differences were observed in response rates (81.6 % vs 89.2 %, p = 0.8), mean reduction of VAS (4.1 +/−2.3 vs 4.9 +/−1.9, p = 0.12) and MPQ scores (1.3 +/−0.9 vs 1.3 +/−0.9, p = 0.9), incidence of PHN after 3 months (48.4 % vs 46.8 %, p = 0.5), and mean AUC during follow-up (199 +/−136 vs 173 +/−141, p = 0.4). No serious treatment-related adverse event was observed in both groups. Conclusions This controlled and randomized trial provides the first evidence of a potential role of AC for the treatment of acute herpetic pain Beschreibung Es handelt sich bei der vorliegenden Arbeit um eine nicht-verblindete, randomisierte klinische Studie, welche den Einfluss der Akupunktur auf die Schmerzentwicklung bei einer Herpes-Zoster(HZ)-Infektion im Vergleich zu einer medikamentösen Standardtherapie (ST) untersucht [1]. Sie wurde als Teil einer Multicenterstudie zur Identifizierung von Risikofaktoren für eine post-herpetische Neuralgie durchgeführt [2]. Als Hauptzielparameter dieser Untersuchung wurde die Reduktion der Schmerzintensität (VAS) nach einer vierwöchigen Behandlungsphase definiert. Sekundäre Zielparameter waren die Responderrate (VAS-Score Reduktion während der Behandlung um mindestens zwei Punkte), die Reduktion der Schmerzintensität nach Behandlung gemessen anhand des McGill Schmerzfragebogens, die Inzidenz einer post-herpetischen Neuralgie (Schmerz im betroffenen Areal drei Monate nach Studieneinschluss), die gesamte Schmerzbelastung während eines einjährigen Follow-ups (Flächeninhalt unter der Ku
ISSN:0415-6412
1439-4359
DOI:10.1016/j.dza.2012.06.008