Acute pain is caused due to an attack on shingles by varicella zoster virus, which usually stops when the shingles rash is cleared and it continues after cure this situation is named as post-herpetic neuralgia (PHN). The condition is more prone in the people with the age more than 70 years. Furthermore, the pain is either regular or non–continuous and is typically painful. Allodynia is a condition refers to the cessation of pain by any stimulus without pain, which is often a stressful feature of PHN. Sleep disturbance and clinical depression are common in this condition. PNH is a commonly occurring condition and frequently encountered in the clinics and various other diagnostic centers globally. According to Journal of the Japan Medical Association, it has been reported that the number of patients is 140–180 per 100,000 population and around 20% of the population suffers from PNH at any age during the lifespan. In Japan, around 500,000 people were affected by herpes zoster in a year.
Another view advocates that neuralgia following herpes zoster should be collectively considered post herpetic pain (PHP), in which PHN is only one constituent. This view regards PHN as “differentiation pain due degeneration of the nerves. According to this theory, transition to PHN is presumed to occur about one month after the onset of herpes zoster and to persist thereafter. However, in many cases of herpes zoster, neuralgia as a form of PHP may be present for 2–3 months after the successful treatment of eruptions, and therefore, it is difficult to form a clear distinction between PHP and PHN.
Drugs which have a direct effect on the nervous system are the most helpful. Drugs used to treat depression can be effective against the nerve pain of post herpetic neuralgia. Antidepressants such as amitriptyline or nor-triptyline must be taken regularly for benefiting the improvement in the condition. Specific problem in patients whose pain remains as post herpetic neuralgia reduced quality of life, which includes correlation between increasing in severity of pain along with the extent of post herpetic neuralgia negative impact on life quality. Furthermore, pain interferes with general activity such as sleep and mood, more severe pain leads to symptoms of anxiety and depression. Instruments involved in health-related quality of life consists four key health domains such as physical, psychological, social, and functional. Both herpes zoster and post herpetic neuralgia have effects on patient life across all the health domains.
Unfortunately, there are currently no absolute prophylaxis for post herpetic neuralgia. However, since post herpetic neuralgia occurs as a sequel to herpes zoster, the prevention of herpes zoster can be useful. In dosage therapy types of antiviral drugs the renal function is considered as an important issue. Dose adjustment strictly necessary for geriatric population along with people with any renal disorder. Furthermore, the dosage regimens of parenteral formulations are described in detail by instructions given by the manufacturer of such dosage forms of the respective drugs, and the treatment of patients should follow the given instructions. In case of renal dysfunction, the dose of the drug is determined as per serum creatinine clearance. Practically, the serum creatinine clearance can be obtained by analyzing serum creatinine level with body weight and age of the patient in terms of a derived formula.
Revenue growth in the post herpetic neuralgia treatment is expected to gain traction in the near future owing to favorable environmental cues in the market such as rise in prevalence of disease caused due to herpes virus. Taking in account all options for treating post herpetic neuralgia are neglected available at different levels is the major factor hindering the market.
Various antiviral drugs for the treatment of post herpetic disorder have been developed and are being used widely in clinical practice currently, although the efficacy few antiviral agents have been denied for post herpetic neuralgia. However, methods of handling patients and the antiviral agent usage in a clinical setting should be taken into account further considering both the prediction and prevention of the onset of herpes zoster and post herpetic neuralgia. Also various topical agents are being approved to cure post herpetic neuralgia, agents such as lidocaine patch applied with a local anesthetic. The treatment can cause local irritation but it is relatively benign in nature. Lidocaine also comes in ointment or cream form in a variety of strengths.
By region, post herpetic neuralgia treatment market is segmented into five regions: North America, Latin America, Europe, Asia-Pacific and the Middle East & Africa. North America dominates the global post herpetic neuralgia treatment market due to rise in awareness of the disorder and introduction of novel drugs.
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Some of the player in the post herpetic neuralgia treatment market are Endo Pharmaceuticals Inc., Depomed, Inc., Acorda Therapeutics.
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