Department of Dermatology, Mayo Clinic, Scottsdale, AZ.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Phoenix, AZ.
Mayo Clin Proc. 2019 Mar;94(3):484-489. doi: 10.1016/j.mayocp.2018.11.004. Epub 2019 Feb 2.
Postherpetic neuralgia (PHN) is the most common complication of varicella zoster virus (VZV) reactivation and a cause of considerable physical and psychosocial morbidity. No known treatment effectively prevents the development of PHN in patients with VZV reactivation. In this study, our objective was to evaluate the efficacy of premedication with gabapentin for reducing the risk of PHN in patients with diabetic and nondiabetic neuropathy. We retrospectively searched the electronic health records of patients with diabetic and nondiabetic neuropathy treated with gabapentin at Mayo Clinic before diagnosis of VZV reactivation. In total, PHN developed in 7 patients with diabetic neuropathy receiving gabapentin (n=62 [11.3%]) compared with 26 not receiving premedication with gabapentin (n=50 [52.0%]) (odds ratio, 0.12; 95% CI, 0.05-0.31; P<.001); PHN developed in 11 patients with nondiabetic neuropathy receiving gabapentin (n=109 [10.1%]) compared with 108 not receiving premedication with gabapentin (n=217 [49.8%]) (odds ratio, 0.11; 95% CI, 0.06-0.22; P<.001). In this cohort of patients with neuropathy, gabapentin administration before the onset of VZV reactivation significantly reduced the risk of PHN.
带状疱疹后神经痛 (PHN) 是水痘-带状疱疹病毒 (VZV) 再激活的最常见并发症，也是导致相当大的身体和心理社会发病率的原因。目前尚无已知的治疗方法能有效预防 VZV 再激活患者发生 PHN。在这项研究中，我们的目的是评估加巴喷丁预先给药降低糖尿病和非糖尿病性神经病变患者发生 PHN 的风险的疗效。我们回顾性地搜索了梅奥诊所接受加巴喷丁治疗的糖尿病和非糖尿病性神经病变患者的电子健康记录，这些患者在 VZV 再激活之前被诊断为患有该疾病。共有 7 例接受加巴喷丁治疗的糖尿病性神经病变患者（n=62 [11.3%]）发生 PHN，而未接受加巴喷丁预先给药的 26 例患者（n=50 [52.0%]）发生 PHN（比值比，0.12；95%CI，0.05-0.31；P<.001）；11 例接受加巴喷丁治疗的非糖尿病性神经病变患者（n=109 [10.1%]）发生 PHN，而未接受加巴喷丁预先给药的 108 例患者（n=217 [49.8%]）发生 PHN（比值比，0.11；95%CI，0.06-0.22；P<.001）。在该神经病变患者队列中，VZV 再激活发作前给予加巴喷丁治疗显著降低了 PHN 的风险。
