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Promising treatment for chronic shingles pain

WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
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5th February 2014 – A new drug treatment has been found to be effective against postherpetic neuralgia - chronic pain resulting from nerve damage caused by shingles.

The drug, called EMA401, targets a different pain mechanism to existing treatments and appears to have fewer side effects.

The Shingles Support Society has welcomed the study results as a "positive development."

Researchers from Imperial College London also hope that the drug could also be effective for other chronic neuropathic pain, caused by diabetes, HIV, nerve injury and chemotherapy cancer treatment, for example.

Shingles pain

Around 190,000 people a year in the UK develop shingles. These people are mostly aged over 50.

Shingles is caused by a dormant viral infection being reactivated in the nerves. It often causes a painful rash for several weeks, but can also cause permanent and painful nerve damage.

This chronic neuropathic pain is called postherpetic neuralgia and affects around 1 in 10 people with shingles.

Current treatments for shingles nerve pain include paracetamol, non-steroidal anti-inflammatory drugs ( NSAIDs), opioids, antidepressants and anticonvulsants. However, some antidepressants and anticonvulsants can cause unpleasant side effects, such as headaches, blurred vision and dizziness.

New drug study

The new drug EMA401 is known as a highly selective angiotensin II type 2 receptor antagonist (AT2R). It was trialled on 183 patients with postherpetic neuralgia in 6 countries with those taking part taking 2 tablets a day for 28 days. Around half the patients took the new drug, the rest were given a placebo or dummy treatment.

The study found that 58% of those taking the new drug found it to be effective, reducing pain by at least 30%.

The study, published in the Lancet, did not report any serious side effects.

In a statement, the lead author of the study Professor Andrew Rice, from the Department of Surgery and Cancer at Imperial College London, says: "A positive trial like this in such a challenging condition as post-herpetic neuralgia, for a drug that acts in a new way, is unusual and very exciting. We hope that the new drug will ultimately offer hope for patients who aren't helped by current treatments."

Larger trials are now being planned to confirm the study's findings. The research was funded by the pharmaceutical company that's developing EMA401.


In a comment article linked to the study, Nanna Brix Finnerup and Cathrine Baastrup from the Danish Pain Research Center, Aarhus University, write that: "It is reasonable to postulate that AT2R antagonists could also be effective in other neuropathic pain disorders, such as peripheral nerve injury and chronic inflammatory pain."

In a statement, Marian Nicholson from the Shingles Support Society says: "This is a positive development and we very much welcome it. Research carried out so far seems to indicate that the treatment is safe, so we hope that new trials with higher doses can make it even more effective.

"Shingles pain, or PHN mainly affects the elderly. It can render a patient's final years an unendurable misery. Prompt treatment may help to prevent this, so we urge anyone who thinks they may have shingles to go to the doctor immediately."

Reviewed on February 05, 2014

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