Efficacy and Safety of Gabapentinoids for Acute Herpes Zoster Neuralgia

Objective: his study aimed to systematically evaluate the clinical efficacy of gabapentin and pregabalin in the treatment of acute herpes zoster neuralgia, including pain control and the occurrence of adverse effects. Method: A systematic computerized search was conducted in October 2023 in PubMed, Embase, Web of Science, Cochrane Library, VIP, CNKI, and Wanfang databases. Data from randomized controlled trials comparing gabapentin analogs for the treatment of acute herpes zoster neuralgia were searched. Endpoints were visual analog scores (VAS) and adverse effects at 1, 2, and 4 weeks. Data from studies that met the inclusion criteria were extracted for meta-analysis and sensitivity analysis using Revman 5.4 and Stata16. Results: The study included 292 patients from 6 RCTs. Of these, 118 were in the gabapentin-treated group, 37 were in the pregabalin-treated group, and 137 were in the placebo-controlled group. The gabapentin group showed superior pain reduction compared to the placebo group ( P <0.05), but adverse events were more frequent. Conclusion: Gabapentin can effectively reduce acute herpes zoster neuralgia in patients. Pregabalin requires additional randomized controlled trials to supplement the analysis. PROSPERO Registration: CRD42023446643.