Stephen Tyring, MD, PhD; Robin L. Saltzman, MD; Robert Dworkin, PhD
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Tyring S, Saltzman RL, Dworkin R. Famciclovir and Postherpetic Neuralgia. Ann Intern Med. 1999;131:712-713. doi: 10.7326/0003-4819-131-9-199911020-00017
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Published: Ann Intern Med. 1999;131(9):712-713.
Bassett and colleagues' calculation of PHN incidence incorrectly assumes that the number of patients included in the “time to loss of PHN” analysis is the total number of patients with “long-term pain” in the entire study sample. In our original paper, the only patients included in the analysis were those who met the predefined study definition of PHN (that is, pain at or after healing). If the point at which lesions healed could not be determined, that patient could not be included in the analysis.
To assess pain prevalence over time in the entire intention-to-treat sample, one must examine the Kaplan-Meier estimates of patients with pain at monthly intervals (Table), as was done in a recently published reanalysis of this trial (1). The proportion of famciclovir recipients with pain does not exceed that of the placebo recipients at any time. Assessment of the relative risk that patients will have pain at monthly intervals after enrollment (placebo compared with famciclovir) also indicates that famciclovir-treated patients have significantly reduced risk for pain 3 to 6 months after rash onset (Table).
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