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A Specific Thrombin Inhibitor, Argatroban, Alleviates Herpes Zoster‐associated Pain
Author(s) -
Fujii Kimio,
Kanno Yuko,
Konishi Kenji,
Ohgou Noriko
Publication year - 2001
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2001.tb00118.x
Subject(s) - medicine , argatroban , anesthesia , adverse effect , thrombin , platelet
We report the result of a randomized, controlled, open trial of anti‐thrombin therapy for herpes zoster‐associated pain. Fifty‐five herpes zoster patients within 8 days after the onset of skin lesion were enrolled in the trial. Patients were treated with an optimal dose of oral acyclovir (4000 mg/day for 7 days) with or without intravenous administration of a specific anti‐thrombin agent, argatroban (10 mg/day, three times a week). Administration of argatroban reduced pain intensity at the 4th through 21st day after the initiation of treatment as determined by visual analogue scale (Mann‐Whitney U test, p<0.05). It also shortened the median time to cessation of analgesic use (14 days vs. 24 days, p =0.02, logrank test), although it did not significantly reduce the median time to cessation of pain (21 days vs. 43 days, p =0.07, logrank test). None of the enrolled patients showed evidence of adverse effects including hemorrhagic diathesis. The results suggested that relatively low doses of argatroban are effective in reducing herpes zoster‐associated pain. Up‐regulation of prothrombin expression by the vascular endothelial and sweat gland epithelial cells in the active skin lesion and transient elevation of plasma thrombin‐antithrombin III complex levels in a proportion of patients suggest a lesional generation of thrombin in herpes zoster. This may be relevant to the beneficial effects of the anti‐thrombin treatment on the resolution of herpes zoster‐associated pain.