Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

2017 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
United States ◽  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Clinical Manifestations ◽  
The United States ◽  
Evidence Based ◽  
Pain Medicine ◽  
High Prevalence ◽  
Antiviral Medications

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

2016 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Clinical Manifestations ◽  
The United States ◽  
Evidence Based ◽  
Pain Medicine ◽  
High Prevalence ◽  
Antiviral Medications ◽  
Physician’S Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. This review contains 6 figures, 4 tables and 13 references Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

scholarly journals Herpes Zoster and Postherpetic Neuralgia: Changing Incidence Rates From 1994 to 2018 in the United States

2020 ◽  
Author(s):  
Ryan R Thompson ◽  
Christina L Kong ◽  
Travis C Porco ◽  
Eric Kim ◽  
Caleb D Ebert ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Age Groups ◽  
The United States ◽  
Incidence Rates ◽  
Prior History ◽  
Administrative Claims ◽  
Current Vaccine ◽  
Vaccine Recommendations

Abstract Background The incidence of herpes zoster (HZ) has been increasing in recent decades. Although 2 vaccines for HZ are available, there have been few studies on the incidence rates of HZ and postherpetic neuralgia (PHN) since their introduction. This study examined the incidence rates of HZ and PHN from 1994 to 2018 in the United States to determine if they have continued to increase since introduction of the HZ vaccines. Methods A de-identified longitudinal administrative claims database, the OptumLabs Data Warehouse, was used to assess incidence rates among individuals continuously enrolled in the database for ≥365 days with no prior history of HZ or PHN. Unstandardized and standardized incidence rates were calculated by year, 10-year age groups, sex, and race/ethnicity. Results There were 610 766 individuals with HZ (median age, 56.3; interquartile range, 43.0–68.7 years; 59.8% women; 70.6% white). From 1994 to 2018, the incidence of HZ increased from 286.0 (95% confidence interval [CI], 259.1–312.8) to 579.6 (95% CI, 554.2–605.0) cases per 100 000 person-years, an annual increase of 3.1% (95% CI, 2.5–3.6%). Since 2007, annual HZ incidence rates have decreased in individuals ≤20 and >60 years old. The overall incidence rate of PHN was 57.5 (95% CI, 56.0–59.0) cases per 100 000 person-years. The proportion of individuals with HZ who developed PHN was higher from 2007 to 2018 than from 1994 to 2006. Conclusions HZ incidence rates have continued to increase in age groups for which HZ vaccines are not currently recommended, warranting a review of current vaccine recommendations.

440: Barriers to the Practice of Evidence Based Urology in the United States

2007 ◽  
Vol 177 (4S) ◽  
pp. 147-148
Author(s):  
Philipp Dahm ◽  
Hubert R. Kuebler ◽  
Susan F. Fesperman ◽  
Roger L. Sur ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Evidence Based

scholarly journals The United States’ Regulatory Environment Is Evolving to Accommodate a Coming Boom in Gene Therapy Research

2019 ◽  
Vol 24 (3) ◽  
pp. 147-152 ◽  
Author(s):  
Daniel Eisenman
Keyword(s):  
United States ◽  
Gene Therapy ◽  
Clinical Trials ◽  
The United States ◽  
Regulatory Environment ◽  
Evidence Based ◽  
Regulatory Structure ◽  
Regulatory Changes ◽  
Current State ◽  
Therapy Field

Introduction: A dramatic increase in the number of clinical trials involving gene-modified cell therapy and gene therapy is taking place. The field is on the verge of a boom, and the regulatory environment is evolving to accommodate the growth. Discussion: This commentary summarizes the current state of the field, including an overview of the growth. The United States (US) regulatory structure for gene therapy will be summarized, and the evolution of the oversight structure will be explained. Conclusion: The gene therapy field has recently produced its first FDA-approved therapeutics and has a pipeline of other investigational products in the final stages of clinical trials before they can be evaluated by the FDA as safe and effective therapeutics. As research continues to evolve, so must the oversight structure. Biosafety professionals and IBCs have always played key roles in contributing to the safe, evidence-based advancement of gene therapy research. With the recent regulatory changes and current surge in gene therapy research, the importance of those roles has increased dramatically.

scholarly journals Annual Incidence Rates of Herpes Zoster among an Immunocompetent Population In The United States

2015 ◽  
Vol 18 (3) ◽  
pp. A232
Author(s):  
B.H. Johnson ◽  
J. Gatwood ◽  
L.A. Palmer ◽  
G. Lenhart ◽  
K. Kawai ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
The United States ◽  
Incidence Rates ◽  
Annual Incidence

The Epidemiology of Herpes Zoster in the United States During the Era of Varicella and Herpes Zoster Vaccines: Changing Patterns Among Older Adults

2018 ◽  
Vol 69 (2) ◽  
pp. 341-344 ◽  
Author(s):  
Rafael Harpaz ◽  
Jessica W Leung
Keyword(s):  
United States ◽  
Older Adults ◽  
Herpes Zoster ◽  
The United States ◽  
Administrative Databases ◽  
Younger Adults ◽  
Incidence Trends ◽  
Changing Patterns ◽  
Herpes Zoster Incidence

Abstract Historic herpes zoster incidence trends in US adults have been hard to interpret. Using administrative databases, we extended previous descriptions of these trends through 2016. We observed an age-specific transition, with ongoing increases among younger adults but deceleration in older adults. The patterns are not readily explained.

Sign in / Sign up

Export Citation Format

Share Document