The Analgesic Efficacy and Safety of Venlafaxine for Prevention of Postherpetic Neuralgia in Patients With Acute Herpes Zoster
The Analgesic Efficacy and Safety of Oral Medications (Venlafaxine) for Prevention of Postherpetic Neuralgia in Acute Herpes Zoster
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Fang Luo
- Phone Number: 13611326978
- Email: 13611326978@163.com
Study Locations
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Beijing, China
- Recruiting
- Beijing Tiantan Hospital, Beijing, Beijing 100070
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Contact:
- Fang Luo
- Phone Number: 13611326978
- Email: 13611326978@163.com
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1. Ages more than 18 years;
- 2. Patients with onset of HZ rash less than 30 days;
- 3. Experiencing moderate to severe HZ pain with an average pain score of at least 4 on a Numeric Rating Scale (NRS, 0 = no pain, 10 = worst possible pain);
- 4. Aspartate aminotransferase and alanine aminotransferase levels less than twice the upper limit of normal;
- 5. Estimated glomerular filtration rate of 30 mL/min per 1.73 m2 or higher;
- 6. Willing to sign the informed consent form and possessing sufficient cognitive and language abilities to comply with all the study requirements.
Exclusion Criteria:
- 1. HZ with head, neck, ocular, mucous membrane, cranial nerve, or central nervous system involvement or generalized HZ;
- 2.Known hypersensitivity to venlafaxine;
- 3. Previous antiviral treatment that did not comply with guideline recommendations;
- 4. History of herpes zoster vaccination before enrollment;
- 5.History of major depressive disorder requiring antidepressant therapy;
- 6.History of systemic immune diseases, organ transplantation, or cancers;
- 7.Pregnancy or lactation;
- 8.Presence of acute or chronic pain disorders other than HZ.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Conventional therapy group
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The control group will receive conventional therapy alone before 90 days after rash onset.
After 90 days from rash onset, treatment will be standardized across both groups.
Participants who develop persistent pain consistent with PHN will receive guideline-based management, including gabapentinoids, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and topical agents such as lidocaine or capsaicin, as clinically indicated.
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Experimental: Venlafaxine combined with conventional therapy group
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Venlafaxine will be initiated at 75 mg once daily and titrated based on pain response and tolerability before 90 days after rash onset.
All participants will receive standardized analgesic management following the World Health Organization pain ladder.
In addition, the group will contain conventional treatment for HZ, including NSAIDs, opioids, antiviral drugs and so on.
After 90 days from rash onset, treatment will be standardized across both groups.
Participants who develop persistent pain consistent with PHN will receive guideline-based management, including gabapentinoids, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and topical agents such as lidocaine or capsaicin, as clinically indicated.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Incidence of PHN
Time Frame: at 90 days after rash onset
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PHN will be defined as persistent pain in the affected dermatome at 90 days after rash onset that is clinically meaningful, operationalized as an average pain score ≥ 3 on the NRS.
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at 90 days after rash onset
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Neuropathic Pain Scale
Time Frame: at or after 90 days following rash onset
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Neuropathic pain characteristics will be assessed using the Neuropathic Pain Scale in participants with developing PHN.
The Neuropathic Pain Scale consists of 10 numeric rating items, each scored from 0 to 10, with higher scores indicating greater neuropathic pain severity.
The scale assesses pain intensity, unpleasantness, and 8 specific pain qualities, including sharp, hot, dull, cold, sensitive, itchy, deep, and surface pain.
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at or after 90 days following rash onset
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The average daily pain intensity
Time Frame: at weeks 1, 2, 4, 8, 12, 24, and 52
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The numeric rating scale (NRS) score is a way to quantify the degree of subjective feelings such as pain using numbers.
Generally, 0 represents no pain, and 10 represents the most severe pain.
A higher score indicates more severe pain.
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at weeks 1, 2, 4, 8, 12, 24, and 52
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The worst numeric rating scale score
Time Frame: at weeks 1, 2, 4, 8, 12, 24, and 52
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The numeric rating scale (NRS) score is a way to quantify the degree of subjective feelings such as pain using numbers.
Generally, 0 represents no pain, and 10 represents the most severe pain.
A higher score indicates more severe pain.
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at weeks 1, 2, 4, 8, 12, 24, and 52
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Proportion of Patients Achieving Pain Reduction
Time Frame: at weeks 1, 2, 4, 8, 12, 24, and 52
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The proportion of patients achieving a ≥ 50% and ≥ 30% reduction in mean baseline pain intensity
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at weeks 1, 2, 4, 8, 12, 24, and 52
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Average weekly consumption of each analgesic class
Time Frame: at weeks 4, 8, 12, 24, and 52
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at weeks 4, 8, 12, 24, and 52
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Herpes Zoster Severity of Illness Index
Time Frame: at weeks 1, 2, 4, 8 and 12
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The HZSOI is a severity-by-duration measure of overall pain burden associated with HZ and is typically calculated as the area under the curve of the worst pain scores over a defined period after rash onset.
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at weeks 1, 2, 4, 8 and 12
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The 12-item Short-Form Health Survey (SF-12) score
Time Frame: at weeks 4, 8, 12, 24, and 52
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The SF-12 score assesses the health-related quality of life, capturing preferences across various health states.
It assesses 8 dimensions: physical functioning, physical role limitations due to physical health, bodily pain, general health, vitality, social functioning, emotional role limitations due to emotional problems, and mental health.
Scores range from 0 to 100 for each dimension, with higher scores indicating better health status.
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at weeks 4, 8, 12, 24, and 52
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The Medical Outcomes Study Sleep Scale (MOS)
Time Frame: at weeks 4, 8, 12, 24, and 52
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The MOS is a questionnaire comprising 12 items that assess various aspects of sleep using a 6-point ordinal scale (1 indicating permanence and 6 indicating absence).
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at weeks 4, 8, 12, 24, and 52
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Adverse events
Time Frame: Through study completion, an average of 52 weeks
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The incidence and proportion of adverse events will be recorded and categorized as mild, moderate, severe, or life-threatening.
AEs are defined as events that arise during treatment, were absent before treatment, or worsen relative to the pretreatment state.
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Through study completion, an average of 52 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
Helpful Links
- Rosamilia LL. Herpes Zoster Presentation, Management, and Prevention: A Modern Case-Based Review. Am J Clin Dermatol. 2020;21(1):97-107.
- Liu Y, Xiao S, Li J, Long X, Zhang Y, Li X. A Network Meta-Analysis of Randomized Clinical Trials to Assess the Efficacy and Safety of Antiviral Agents for Immunocompetent Patients with Herpes Zoster-Associated Pain. Pain Physician. 2023;26(4):337-46.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Varicella Zoster Virus Infection
- Neurologic Manifestations
- Nervous System Diseases
- Neuromuscular Diseases
- Infections
- Virus Diseases
- Peripheral Nervous System Diseases
- DNA Virus Infections
- Herpesviridae Infections
- Neuralgia
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Pain
- Herpes Zoster
- Neuralgia, Postherpetic
Other Study ID Numbers
Other Study ID Numbers
- KY2025-369-02-3
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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