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Postherpetic Neuralgia in Herpes Zoster—Reply
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In Reply: Dr Zhou and colleagues address several points regarding my Clinical Crossroads article. They are correct in noting an inaccuracy in the article regarding their Cochrane review. The sentence in question should have read, "A Cochrane review of antiviral treatment for preventing PHN reported no benefit of acyclovir for reducing the incidence of PHN; there was insufficient evidence to determine the efficacy of other antivirals." A correction appears in this issue of JAMA.
I stand by my statement that "[p]revention of PHN is a major concern because antiviral drugs alone do not reliably prevent this complication." The US Food and Drug Administration (FDA), using the definition of PHN cited by Zhou et al, concluded that although treatment may decrease the median duration of pain (as a continuum), the data from well-controlled clinical trials did not provide evidence of reduction of PHN for any of the licensed drugs: acyclovir,1 . . . [Full Text of this Article]
Richard J. Whitley, MD
rwhitley@peds.uab.edu
Department of Pediatrics
University of Alabama at Birmingham
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