About this trial
Herpes zoster (HZ) is characterized by a painful dermatomal rash and significantly affects quality of life, with acute pain increasing the risk of postherpetic neuralgia. Although early antiviral therapy limits viral replication, its analgesic effect is insufficient, and many patients experience inadequate relief despite stepwise use of non-opioids and opioids. Recent attention has focused on the potential role of muscle relaxant, which can relieve skeletal muscle spasms and associated pain in acute musculoskeletal conditions. Therefore, investigators hypothesize that baclofen may effectively reduce the severity of HZ pain without significantly increasing adverse events.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
1. Ages more than 18 years;
2. Patients with onset of HZ rash less than 90 days;
3. Experiencing moderate to severe HZ pain with an average pain score of at least 4 on a Numeric Rating Scale (NRS, 0 = no pain, 10 = worst possible pain);
4. Aspartate aminotransferase and alanine aminotransferase levels less than twice the upper limit of normal;
Disqualifiers
1. History of taking baclofen;
2. Patients with evidence of cutaneous or visceral dissemination of HZ infection (cutaneous dissemination is defined as more than 20 discrete lesions outside adjacent dermatomes) or ocular involvement of HZ;
3. History of intolerance or hypersensitivity to any active components or excipient of the baclofen;
4. History of systemic immune diseases, organ transplantation, or cancers;
Trial design
Parallel
Treatments tested in this trial
Baclofen combined conventional therapy
DrugIn the baclofen combined conventional therapy group, baclofen will be initiated at 15 mg daily. Then, based on the patient's response, the single dose can be gradually increased by 5mg each time, with a three-day interval. The maximum recommended dose is 30\~75mg daily. In addition, the group will contain conventional treatment for HZ, except baclofen, including NSAIDs, opioids, antiviral drugs and so on.
Conventional therapy
DrugIn the conventional therapy group, treatments will include NSAIDs, opioids, antiviral drugs and so on.
Treatment groups
Trial outcomes
Primary outcomes
the average numeric rating scale score over the past 24 hours, rated each morning upon awakening and average over 7 days.
The numeric rating scale (NRS) score is a way to quantify the degree of subjective feelings such as pain using numbers. Generally, 0 represents no pain, and 10 represents the most severe pain. A higher score indicates more severe pain.
Secondary outcomes
The worst numeric rating scale score
The numeric rating scale (NRS) score is a way to quantify the degree of subjective feelings such as pain using numbers. Generally, 0 represents no pain, and 10 represents the most severe pain. A higher score indicates more severe pain.
Proportion of Patients Achieving Pain Reduction
The proportion of patients achieving a ≥ 50% and ≥ 30% reduction in mean baseline pain intensity
Proportion of patients developing postherpetic neuralgia
The type of analgesics and average weekly consumption per analgesics
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