ATHENA: AmiTritypline for the prevention of post-HErpetic NeuralgiA
فنڈنگ
National Institute for Health (NIHR) Health Technology Assessment (HTA) Ref. NIHR129720
تحقیقی سوال کیا ہے؟
What is the effectiveness of prophylactic low-dose amitriptyline for the prevention of post-herpetic neuralgia in patients diagnosed with herpes zoster?
مسئلہ کیا ہے؟
Shingles is caused by the same virus that causes chickenpox. It “sleeps” in the nerve cells for decades. When it “wakes up”, it can make people feel generally unwell, causing tingling or pain in one part of the body, followed a few days later by a rash. The rash can take up to 4 weeks to heal.
Antiviral medicine helps reduce initial pain and rash severity. Some people can have “nerve pain” called post-herpetic neuralgia months after the shingles rash has gone. We don’t have any treatments to prevent this.
Patients buy and GPs prescribe painkillers such as paracetamol, but they often don’t help. Amitriptyline is an old medicine, originally used at high doses (75-150 mg) to treat depression but now used at low doses for nerve pain. A small study published in 1997 suggested that taking a low dose (25 mg) of amitriptyline early on may help prevent post-herpetic neuralgia.
تحقیق کا مقصد کیا ہے؟
We want to do a larger study to find out if using amitriptyline when the rash first appears prevents pain later. If starting amitriptyline early on does help, it is a cheap medicine that would prevent prolonged, difficult-to-treat pain for thousands of people.
However, amitriptyline commonly causes side effects such as dizziness, dry mouth and constipation. It can also cause problems when used together with some other medications. This study is needed so we can be sure that any benefits outweigh the harm.
یہ کیسے حاصل ہوگا؟
We will recruit 846 people aged >50 diagnosed by their GP with shingles within 72 hours of the rash appearing.
We will ask everyone to take tablets nightly for 10 weeks: half will be given amitriptyline and the other half will get placebo (or “dummy”) tablets.
Neither patients nor their doctors can choose which group they are in. This will be done by a computerised process called “randomisation” – like rolling a dice to decide. This way the results cannot be affected by anyone’s beliefs about amitriptyline.
All other care will be the same – GPs prescribing antivirals and painkillers if needed. We will use questionnaires to understand what happens to everyone over the following 12 months, especially whether they still have pain related to shingles at 3 months.
تحقیق کی قیادت کون کر رہا ہے؟
ڈاکٹر میتھیو رڈ، پرائمری ہیلتھ کیئر، پاپولیشن ہیلتھ سائنسز، یونیورسٹی آف برسٹل میں جی پی اور ریڈر۔.
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