Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy.
Eur Rev Med Pharmacol Sci. 2022 May;26(10):3664-3676. doi: 10.26355/eurrev_202205_28862.
Chronic pain is currently considered a disease state with biopsychosocial consequences and a negative impact on patients' quality of life (QoL). Pain from postherpetic neuralgia (PHN) can persist for months or years and is a prototypical example of chronic pain. We analyzed PHN as a model of chronic pain, including its effects on QoL and clinical aspects. We explored treatment options, focusing on the topical treatment with lidocaine 700 mg medicated plaster (LMP) and how this impacts PHN management.
This article is a narrative review of published studies. Preclinical and clinical studies were retrieved from literature through a search performed in PubMed/MEDLINE.
To choose the appropriate treatment for chronic pains, such as PHN, not only efficacy but also tolerability, manageability, practicality, and compliance are important factors, especially in the long term. It is also important to set treatment expectations with the patients as total suppression of pain may be unrealistic, and a balance needs to be found between pain control and the minimization of adverse events. In this respect, LMP may be the best currently available treatment: it is easy to use, has low systemic absorption and thus a low risk for pharmacological interactions. Therefore, treatments can be personalized, and concomitant medications can be added, if needed. Recent data from a real-world study support this view by showing that LMP has superior effectiveness in reducing pain and improving the QoL compared to other commonly used systemic treatments and confirming its good tolerability profile that is mainly characterized by localized skin reactions.
LMP is one of the best currently available treatment options for PHN patients balancing good efficacy with an excellent tolerability profile and can therefore be considered for use as a first-line treatment for PHN.
慢性疼痛目前被认为是一种具有生物心理社会后果的疾病状态，会对患者的生活质量（QoL）产生负面影响。带状疱疹后神经痛（PHN）的疼痛可持续数月甚至数年，是慢性疼痛的典型范例。我们分析了 PHN 作为一种慢性疼痛模型，包括其对 QoL 和临床方面的影响。我们探讨了治疗选择，重点是利多卡因 700mg 贴剂（LMP）的局部治疗以及这对 PHN 管理的影响。
这是一篇已发表研究的叙述性综述。通过在 PubMed/MEDLINE 上进行检索，从文献中检索到了临床前和临床研究。
为了选择合适的治疗方法来治疗慢性疼痛，如 PHN，不仅疗效，而且耐受性、可管理性、实用性和依从性都是重要因素，尤其是在长期治疗中。与患者一起设定治疗预期也很重要，因为完全抑制疼痛可能不现实，需要在疼痛控制和最小化不良事件之间找到平衡。在这方面，LMP 可能是目前最好的治疗方法：它易于使用，全身吸收低，因此发生药物相互作用的风险低。因此，可以根据需要个性化治疗，并添加伴随药物。最近一项真实世界研究的数据支持了这一观点，表明 LMP 在减轻疼痛和改善 QoL 方面比其他常用的全身治疗更有效，并证实了其良好的耐受性，主要表现为局部皮肤反应。
LMP 是 PHN 患者目前可用的最佳治疗选择之一，在疗效和良好的耐受性之间取得了平衡，因此可以考虑将其作为 PHN 的一线治疗。
