Pain Management in Postherpetic Neuralgia: Emerging New Therapeutic Options Besides Spinal Cord Stimulation

摘要

I read with great interest the recent article by Yanamoto and Murakawa in a recent issue of your esteemed journal (1). The article is highly thought provoking. Interestingly, the past few years have seen the emergence of a number of new options besides spinal cord stimulation that are increasingly and effectively being used for the treatment of postherpetic neuralgia (PHN).For instance,Tumor necrosis factor-alpha (TNG-a) inhibitors such as adalimumab are rapidly emerging as a highly effective alternative to traditional drugs for PHN. In fact, the incidence rate in patients with herpes zoster who are treated with TNF-a inhibitors is as low as 0.9% (2). Another recent discovery is the development of a concentrated 8% dermal patch—the NGX-4010. PHN-associated pain is diminished for almost three months following a single one-hour application of NGX-4010 (3). Subcutaneous administration of botu-linum toxin A also is being increasingly and successfully used in the treatment of PHN (4).