ACTH versus prednisone and placebo in herpes zoster treatment

The effect of ACTH (Synacthen-depot®) versus prednisone and placebo in the treatment of herpes zoster (HZ) was studied in a controlled clinical trial comprising 60 consecutive patients. The treatment groups were comparable regarding sex, age and pre-entry symptom duration. The skin changes, patients' pain scores and the consumption of analgesics were monitored. Regarding objective symptoms and the development of postherpetic neuralgia there was no difference between the two treatment groups and placebo, while the ACTH group showed a decrease in pain score and consumption of analgesics during the first 4 days of the trial. Whether this finding will justify the application of ACTH in early HZ is arguable. Neither ACTH nor prednisone influenced the development of postherpetic neuralgia but this negative finding may be inaccurate due to the small number of patients in the three groups. Severe side-effects did not occur.