Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 20;24(16):12987.
doi: 10.3390/ijms241612987.

Investigational Drugs for the Treatment of Postherpetic Neuralgia: Systematic Review of Randomized Controlled Trials

Miguel Á Huerta  1   2 , Miguel M Garcia  3   4 , Beliu García-Parra  5 , Ancor Serrano-Afonso  6 , Nancy Paniagua  3   4
Affiliations

Investigational Drugs for the Treatment of Postherpetic Neuralgia: Systematic Review of Randomized Controlled Trials

Miguel Á Huerta et al. Int J Mol Sci. .

Abstract

The pharmacological treatment of postherpetic neuralgia (PHN) is unsatisfactory, and there is a clinical need for new approaches. Several drugs under advanced clinical development are addressed in this review. A systematic literature search was conducted in three electronic databases (Medline, Web of Science, Scopus) and in the ClinicalTrials.gov register from 1 January 2016 to 1 June 2023 to identify Phase II, III and IV clinical trials evaluating drugs for the treatment of PHN. A total of 18 clinical trials were selected evaluating 15 molecules with pharmacological actions on nine different molecular targets: Angiotensin Type 2 Receptor (AT2R) antagonism (olodanrigan), Voltage-Gated Calcium Channel (VGCC) α2δ subunit inhibition (crisugabalin, mirogabalin and pregabalin), Voltage-Gated Sodium Channel (VGSC) blockade (funapide and lidocaine), Cyclooxygenase-1 (COX-1) inhibition (TRK-700), Adaptor-Associated Kinase 1 (AAK1) inhibition (LX9211), Lanthionine Synthetase C-Like Protein (LANCL) activation (LAT8881), N-Methyl-D-Aspartate (NMDA) receptor antagonism (esketamine), mu opioid receptor agonism (tramadol, oxycodone and hydromorphone) and Nerve Growth Factor (NGF) inhibition (fulranumab). In brief, there are several drugs in advanced clinical development for treating PHN with some of them reporting promising results. AT2R antagonism, AAK1 inhibition, LANCL activation and NGF inhibition are considered first-in-class analgesics. Hopefully, these trials will result in a better clinical management of PHN.

Keywords: AAK1; AT2R; COX; LANCL; NMDA; analgesic; first in class; nerve growth factor; neuropathic pain; opioid.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Summary of the sensory alterations experienced during postherpetic neuralgia.
Figure 2
Figure 2
Study selection flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Johnson R.W., Rice A.S.C. Clinical Practice. Postherpetic Neuralgia. N. Engl. J. Med. 2014;371:1526–1533. doi: 10.1056/NEJMcp1403062. - DOI - PubMed
    1. Thompson R.R., Kong C.L., Porco T.C., Kim E., Ebert C.D., Acharya N.R. Herpes Zoster and Postherpetic Neuralgia: Changing Incidence Rates from 1994 to 2018 in the United States. Clin. Infect. Dis. 2021;73:e3210. doi: 10.1093/cid/ciaa1185. - DOI - PMC - PubMed
    1. Hadley G.R., Gayle J.A., Ripoll J., Jones M.R., Argoff C.E., Kaye R.J., Kaye A.D. Post-Herpetic Neuralgia: A Review. Curr. Pain Headache Rep. 2016;20:17. doi: 10.1007/s11916-016-0548-x. - DOI - PubMed
    1. Mallick-Searle T., Snodgrass B., Brant J.M. Postherpetic Neuralgia: Epidemiology, Pathophysiology, and Pain Management Pharmacology. J. Multidiscip. Healthc. 2016;9:447. doi: 10.2147/JMDH.S106340. - DOI - PMC - PubMed
    1. Dworkin R.H., Portenoy R.K. Pain and Its Persistence in Herpes Zoster. Pain. 1996;67:241–251. doi: 10.1016/0304-3959(96)03122-3. - DOI - PubMed

Publication types