Analgesic Efficacy of Mirogabalin in Patients With Herpes Zoster: Protocol for a Prospective Multicenter Randomized Open-Label Blinded-Endpoint (PROBE) Study

Background

Herpes zoster (HZ) is a debilitating condition characterized by acute dermatomal pain and a high risk of developing postherpetic neuralgia (PHN). Although early antiviral therapy is essential, its analgesic efficacy is often insufficient, particularly in patients with moderate to severe pain. While gabapentinoids are recommended as adjunctive analgesics, current options like gabapentin and pregabalin are often limited by inconsistent efficacy and dose-dependent adverse events. Mirogabalin, a novel gabapentinoid with higher affinity and selective dissociation for the a2d subunit, may offer superior pain relief with a wider safety margin. However, although mirogabalin has demonstrated efficacy in PHN, its analgesic efficacy and safety in patients with acute HZ-associated pain have not been adequately established.