Objective: The purpose was to evaluate the efficacy of methylprednisolone combined with local anesthetics on the incidence or intensity of long-term Postherpetic neuralgia (PHN).
Methods: We have performed comprehensive literature research in PubMed, Web of Science, Cochrane library, and China national knowledge infrastructure (CNKI) databases (inception through October 19 2021). Relevant randomized controlled trials (RCTs) with long-term duration were included, regardless of the injection method. The indicators were the incidence of PHN and the Visual Analog Scale (VAS) scores.
Results: Five RGTs with 980 patients were retrieved. Compared with standard treatment (antivirals) alone, the combination of methylprednisolone, local anesthetic, and standard treatment exhibited a significant decrease in the incidence of PHN in 1 month (RR = 0.38, 95% confidence interval (CI): 0.19-0.76), 3 months (RR = 0.40, 95% CI: 0.19-0.84), and 6 months (RR = 0.37, 95% CI: 0.15-0.94) after zoster onset. In VAS scores, there was also a significant difference between the two groups in long-term PHN (3 months: WMD=-1.57, 95% CI: -2.84 to -0.30; 6 months: WMD=-0.72, 95% CI: -1.29 to -0.16).
Conclusion: The combination of methylprednisolone, local anesthetic, and standard treatment appears to be an ideal option for patients with PHN. Further investigation is needed for the safety of this therapy.
Keywords: Postherpetic neuralgia; local anesthetic; meta-analysis; methylprednisolone; systematic review.