Study designs of evaluations included in the review
Reviews, letters editorials and single case reports were excluded, but otherwise, the inclusion criteria were not explicitly defined in terms of the study design. The included studies were non-blinded and double-blinded randomised controlled clinical trials (RCTs), non-randomised controlled clinical trials, and case series.
Specific interventions included in the review
Studies that focused on the use of corticosteroids for treatment or prevention were eligible for inclusion. One study in which all patients received corticosteroids was excluded. The included studies used oral, topical and injectable corticosteroids (intralesional, intrathecal and epidural).
The included studies used the following regimens for herpes zoster: oral prednisone and prednisolone, starting dose from 35 to 60 mg/day, generally tapering over 3 to 4 weeks; oral triamcinolone, 48 mg/day and tapering; corticotropin, 1 mg thrice weekly for 7 weeks; carbamazepine, 400 mg /day for 4 weeks; aciclovir, 4,000 mg/day or 7 to 21 days; radiotherapy; prednisolone or prednisone plus aciclovir; placebo; and no treatment. Various analgesics were also used as cointerventions or controls.
The included studies used the following regimens for herpes zoster opthalmicus: betamethasone; unspecified corticosteroid; aciclovir ointment (3%) with and without corticosteroids; and dexamethasone (0.01 to 0.1%). Treatment was generally applied five times daily.
The included studies used the following injectable corticosteroid regimens for acute herpes zoster and postherpetic neuralgia: corticotropin, 20 to 75 mg/day; triamcinolone (2 to 80 mg) plus lidocaine, procaine or saline; cortisone; methylprednisolone plus lidocaine, bupivacaine or epidural bupivacaine; intrathecal or epidural methylprednisolone (60 mg) plus lidocaine weekly for 4 weeks; intrathecal lidocaine weekly for 4 weeks; and no intrathecal injection.
Participants included in the review
Studies of people with herpes zoster, postherpetic neuralgia and/or ocular complications of herpes zoster were eligible for inclusion.
Outcomes assessed in the review
Studies that reported effectiveness and tolerability were eligible for inclusion. The included studies assessed acute pain relief, the development of postherpetic neuralgia, and the relief of postherpetic neuralgia.
How were decisions on the relevance of primary studies made?
The author did not state how the papers were selected for the review, or how many reviewers performed the selection.