IASP 14th World Congress on Pain 2012, Milan
AACHEN, Germany, September 5, 2012 /PRNewswire/ –
Targeted Treatment for Patients Suffering from Postherpetic Neuralgia: It’s a Control
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Ask pain patients what they expect from their treatment and the answer is simple: “I
want to sleep through the whole night,” or, “I want to be able to walk with my wife.” They
want relief with minimal side effects to master a normal life. Therefore, people with
chronic pain may also be attracted to treatments offering flexibility; a sense of control
over their disease even when pain management is required for extended periods.
Experts addressing a symposium hosted by Gruenenthal at the 14th World Congress on
Pain in Milan said topical treatment with a 5% lidocaine medicated plaster, can help
improve quality of life for patients with post-herpetic neuralgia (PHN), without a high
risk of interacting with other medications or impairing cognitive performance.
PHN is a form of neuropathic pain that occurs after reactivation by the varicella
zoster virus (shingles). Some people develop chronic pain after healing from shingles.
They suffer from localised symptoms such as constant burning, stabbing and shooting pain,
allodynia and hyperalgesia. In up to 20%  of people reactivation of the virus occurs at
some point in their lives, with between 8% and 19% of these individuals developing PHN.
The burden of PHN is significant. Up to 90% of PHN patients have allodynia which can
have a major impact on quality of life and potentially lead to depression., Severe
pain has also been shown to impair day-to-day functioning and work performance.
Helping patients to live a normal life is a central goal of PHN management. Current
pharmacological treatment options for PHN include systemic and topical therapy.
Topical treatment combines proven efficacy and excellent tolerability
Dr Winston de Mello, University Hospital of South Manchester, United Kingdom, said
there can be considerable delay in the diagnosis and appropriate treatment of PHN, and
many treatment options are typically associated with side effects which are detrimental to
patients’ quality of life. “The prevalence of PHN increases with age so many of our
patients are also taking medications for other conditions. The potential for drug
interactions must be considered when selecting a treatment. That is one of the benefits of
lidocaine plasters: its topical administration is associated with low systemic side
effects,” he said.
PHN patients typically suffer from localised pain symptoms such as burning, stabbing,
shooting pain, or allodynia and hyperalgesia. Using a medicated plaster allows patients to
apply treatment directly to the painful area, Dr de Mello added. Titration is not
necessary and patients can use up to three plasters to cover the most painful parts.
Neuropathic pain influences cognitive functioning – how can this impairment be
The impact of PHN on cognitive processes is currently being studied by researchers at
the National Institute of Health and Research (INSERM) at University Regional Hospital,
Clermont-Ferrand, France. Speaking at the symposium, Dr Gisele Pickering gave the audience
an insight into some of the key findings emerging from her work. The impact of pain
treatments on cognition was assessed in a cohort study including 88 individuals (44 men
and 44 women aged 72 years +/- 8). The healthy volunteers were used as a control group
while the PHN patients were split into two subgroups: 21 patients were given classical
systemic treatment for neuropathic pain (antidepressants, anticonvulsants and opiates),
and 21 patients were treated with topical 5% lidocaine administered through a hydrogel
Reaction time, semantic memory, decision-making, spatial memory and executive function
were examined. The research found that reaction time, decision making and semantic memory
were impaired in the group of PHN patients who were given systemic treatments. In
contrast, no significant changes were found in the performance of the group treated with
lidocaine compared to the healthy group.
“This study shows the deleterious effect of treated post-herpetic neuropathic pain on
several domains of cognition. These findings are due to the pain itself and also to the
side-effects of classical treatments that need to be explored further. Topical treatment
with 5% lidocaine medicated plaster is a valuable alternative in post-herpetic pain
alleviation and maintains cognitive integrity in this vulnerable population,” said Dr
Up to 4-year clinical data confirms sustained long-term effect
Prof. Dr Gunnar Wasner, a consultant neurologist at the Department of Neurology and
the Division of Neurological Pain Research and Therapy, Christian-Albrechts-University,
Kiel, Germany, explained how 5% lidocaine medicated plaster works and discussed new safety
data. He said the lidocaine plasteroffers instant cooling and soothing effects and
protects the painful area from rubbing. The plaster is easy to administer and can be
customised to fit the area of pain. The lidocaine contained in the plaster diffuses
continuously into the skin, providing a cumulative local analgesic effect. Lidocaine is a
voltage-gated sodium channel antagonist which inhibits the generation and conduction of
nerve impulses. The hydrogel plaster acts specifically on abnormally excitable, damaged
A- and C-fibres by blocking the sodium channels that they express in high number. This
leads to a stabilisation of the neuronal membrane potential, resulting in a reduction of
ectopic discharges. The responder rate of 62% is comparable to systemic treatments
and more than 80% of responding patients experience pain relief within the first two
weeks. In terms of safety, Prof. Wasner said side effects from topical lidocaine are
minimal. “All adverse reactions were predominantly of mild and moderate intensity. Of
those less than 5% lead to treatment discontinuation.” He outlined data from a study
which looked at the tolerability of topical lidocaine in patients treated between one and
four years. Patients reported between “moderate” and “a lot of” pain relief throughout
the treatment period. Investigators rated the change in patients’ condition as “very much
improved” or “much improved” in about 80% of patients at their final visit.
“The 5% lidocaine medicated plaster has a proven long-term efficiency in neuropathic
pain associated with post-herpetic neuralgia (PHN). It has a favourable safety and
tolerability profile, allowing long-term use by PHN patients without tolerance problems.
Studies show the hydrogel plaster has – due to its topical administration – minimal risk
of systemic side effects and patients experience minimal risk of drug-drug interactions.
This supports patient compliance with physician-prescribed treatment. The lidocaine
plasteris recommended in international guidelines as a first-line treatment for PHN,”
Prof. Wasner said.
About PHN (post-herpetic neuralgia)
PHN is a neuropathic pain condition that remains after healing of herpes zoster
lesions or rash. It manifests itself in various forms of local or peripheral pain symptoms
such as constant burning sensations, stabbing and shooting pains, allodynia and
About IASP(R) 14th World Congress on Pain
The IASP(R) World Congress on Pain is the world’s premier conference on pain research
and treatment, held this year at the Milan Convention Centre from 27th-31st August. The
scientific program consists of a variety of sessions designed to benefit both those who
are new to or experienced in pain management through the presentation of promising
research and treatment possibilities. For more information on IASP(R) 2012, please visit
The Gruenenthal Group is an independent, family-owned, international research-based
pharmaceutical company headquartered in Aachen, Germany. Building on its unique position
in pain, its objective is to become the most patient-centric company to be a leader in
therapy innovation. Gruenenthal is one of the last five research-oriented pharmaceutical
corporations with headquarters based in Germany which sustainably invests in research and
development. These investments amounted to about 25% of revenues in 2011. Gruenenthal’s
research and development strategy concentrates on select fields of therapy and
state-of-the-art technologies. We focus on the intensive search for new ways to treat pain
better, more effectively and with fewer side-effects than before. Altogether, the
Gruenenthal Group has affiliates in 26 countries worldwide. Gruenenthal products are sold
in more than 155 countries and approx. 4,200 employees are working for the Gruenenthal
Group worldwide. In 2011, Gruenenthal reached revenues of 947M EUR. More information:
For more information on the 5% lidocaine medicated plaster, please visit
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Product Contact: Jeanette Huebsch, Senior Manager Versatis, Gruenenthal Europe & Australia Phone: +49-241-569-1487, Fax: +49-241-569-3474 firstname.lastname@example.org
Gruenenthal GmbH, 52099 Aachen, Germany, http://www.grunenthal.com
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