+1 Recommend
1 collections
      • Record: found
      • Abstract: found
      • Article: found

      European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 2: Treatment

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction in the incidence of postherpetic neuralgia (PHN) and other complications. The guideline development followed a structured and pre-defined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence-Based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this second part of the guideline, therapeutic interventions have been evaluated. The expert panel formally consented recommendations for the treatment of patients with HZ (antiviral medication, pain management, local therapy), considering various clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regard to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.

          Related collections

          Most cited references 53

          • Record: found
          • Abstract: found
          • Article: not found

          GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations.

          This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to classifying the direction and strength of recommendations. The strength of a recommendation, separated into strong and weak, is defined as the extent to which one can be confident that the desirable effects of an intervention outweigh its undesirable effects. Alternative terms for a weak recommendation include conditional, discretionary, or qualified. The strength of a recommendation has specific implications for patients, the public, clinicians, and policy makers. Occasionally, guideline developers may choose to make "only-in-research" recommendations. Although panels may choose not to make recommendations, this choice leaves those looking for answers from guidelines without the guidance they are seeking. GRADE therefore encourages panels to, wherever possible, offer recommendations. Copyright © 2013. Published by Elsevier Inc.
            • Record: found
            • Abstract: found
            • Article: not found

            Recommendations for the management of herpes zoster.

            The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster (HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic literature reviews, published randomized clinical trials, existing guidelines, and the authors' clinical and research experience relevant to the management of patients with HZ were reviewed at a consensus meeting. The results of controlled trials and the clinical experience of the authors support the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir as first-line antiviral therapy for the treatment of patients with HZ. Specific recommendations for the use of these medications are provided. In addition, suggestions are made for treatments that, when used in combination with antiviral therapy, may further reduce pain and other complications of HZ.
              • Record: found
              • Abstract: found
              • Article: not found

              A systematic review and meta-analysis of risk factors for postherpetic neuralgia

              Supplemental Digital Content is Available in the Text.

                Author and article information

                Journal of the European Academy of Dermatology and Venereology
                J Eur Acad Dermatol Venereol
                January 2017
                January 2017
                November 02 2016
                : 31
                : 1
                : 20-29
                [1 ]Department of Dermatology; Venereology and Allergology; Division of Evidence-Based Medicine in Dermatology (dEBM); Charité - Universitätsmedizin Berlin; Berlin Germany
                [2 ]Department of Dermatology; University Medical Center of Liège; Liège Belgium
                [3 ]Department of Dermatology and Venereology; University Hospital Center Zagreb, University of Zagreb School of Medicine; Zagreb Croatia
                [4 ]Department of Anesthesiology; Charité - Universitätsmedizin Berlin; Berlin Germany
                [5 ]Department of Dermatology; Poznan University of Medical Sciences; Poznan Poland
                [6 ]Department of Otorhinolaryngology; The Medical School; University of Malta; Msida Malta
                [7 ]Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
                [8 ]Division of Infection and Immunity; University College London; London United Kingdom
                [9 ]Department of Medicine; Section of Dermatology and Venereology; University of Verona; Verona Italy
                [10 ]Department of Dermatology and Venerology; Universitätsklinik Rostock; Rostock Germany
                [11 ]Faculty of Epidemiology and Population Health; London School of Hygiene and Tropical Medicine; London UK
                [12 ]Department of Ophthalmology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
                [13 ]Department of Otolaryngology; University Hospital Aintree NHS Foundation Trust; Liverpool UK
                [14 ]Department of Ophthalmology; Charité - Universitätsmedizin Berlin; Berlin Germany
                [15 ]Department of Neurology; Christian Doppler Medical Center; Paracelsus Medical University; Salzburg Austria
                [16 ]Department of Viroscience; Erasmus MC; Rotterdam The Netherlands
                [17 ]Department of Virology and Antiviral Therapy; Jena University Hospital; Jena Germany
                © 2016


                Comment on this article