Impact of Herpes Zoster and Post-Herpetic Neuralgia on Health-Related Quality of Life in Japanese Adults Aged 60 Years or Older: Results from a Prospective, Observational Cohort Study

Abstract

Background and objectives: Herpes zoster (HZ) and its most frequent complication, post-herpetic neuralgia (PHN), have been shown to considerably impact quality of life (QoL). This has not yet been demonstrated in Japan.

Methods: QoL in HZ and PHN patients was evaluated using the Zoster Brief Pain Inventory (ZBPI), EuroQoL-5 Dimension (EQ-5D), Short-Form 12 version 2.0, and short-form McGill Pain Questionnaire up to 270 days after rash onset as part of a prospective, observational, cohort study conducted in Kushiro, Hokkaido, Japan.

Results: This study involved 412 adults ≥ 60 years of age diagnosed with HZ, 38 of whom developed PHN. QoL in daily activity performance and emotional and physical functioning was impaired at Day 0 (rash onset) and almost resolved by Day 90. Although the mean ZBPI worst pain score for HZ patients without PHN improved from 4.1 at Day 0 to 0.1 at Day 90, the score for HZ patients with PHN at Day 90 was comparable to that for HZ patients without PHN at Day 0. While the EQ-5D score in HZ without PHN improved, on average, from 0.755 to 0.949, the score for HZ with PHN was dependent on PHN duration and did not improve until PHN disappearance.

Conclusions: HZ impaired QoL in daily activity performance and emotional and physical functioning. The negative impact on QoL was more prevalent in patients with a longer PHN duration compared with HZ without PHN. ClinicalTrials.gov identifier: NCT01873365.

Conflict of interest statement

Conflict of interest

Koichi Adachi received a study grant from the GSK group of companies, personal fees for medical advice during the conduct of the study, and personal fees for lectures from the GSK group of companies outside the submitted work. Katsiaryna Holl, Desmond Curran, Keiko Sato and Toshihiko Kaise are employees of the GSK group of companies and hold shares in the GSK group of companies as part of their employee remuneration. Taizo Matsuki and Akiko Mizukami are employees of the GSK group of companies. Sean Matthews is a freelance consultant working on behalf of GSK. KS, TK, TM, and AM received funding from Japan Vaccine Co. Ltd (a 50/50 joint venture of GSK/Daiichi Sankyo Company, Ltd) for the conduct of the study.

Funding

GlaxoSmithKline Biologicals SA funded the study and was involved in all study activities and overall data management (collection, analysis and interpretation). They also funded all costs associated with developing and publishing this manuscript. All authors had full access to the data, and the corresponding author was responsible for submission of the publication (ClinicalTrials.gov identifier: NCT01873365).

Figures

Fig. 1

Changes in ZBPI worst pain score over time. The symbol and vertical bar represent the mean and standard deviation. The number of data collected at each point is included in Table 3. HZ herpes zoster, PHN post-herpetic neuralgia, ZBPI Zoster Brief Pain Inventory

Fig. 2

Interference of HZ-associated pain with ZBPI ADL scores over time. The symbol and vertical bar represent the mean and standard deviation. HZ herpes zoster, PHN post-herpetic neuralgia, ZBPI Zoster Brief Pain Inventory, ADL activities of daily living

Fig. 3

Pain descriptions at rash onset. a Rate of responses as severe for Pain Rating Index; and b Present Pain Intensity

Fig. 4

Changes in EQ-5D utility score over time. The symbol and vertical bar represent the mean and standard deviation. The number of data collected at each point is included in Table 4. HZ herpes zoster, PHN post-herpetic neuralgia, EQ-5D EuroQoL-5 Dimension

Fig. 5

SF-12 scores by age group at Day 0 and Day 90. SF-12 Short-Form 12 version 2.0, PF physical functioning, RP role-physical, BP bodily pain, GH general health, VT vitality, SF social functioning, RE role-emotional, MH mental health, PCS physical health component score, MCS mental health component score