Topical Lidocaine Medicated Plaster 5% and Pregabalin for the Treatment of Post-Herpetic Neuralgia: A Systematic Review and Meta-Analysis

Background and objectives: Post-herpetic neuralgia is common severe pain that leads to poor quality of life. Various topical and systemic drugs were in use including topical lidocaine medicated plaster 5% (05% LMP. This is the first meta-analysis to compare 5% lidocaine medicated plaster and pregabalin. Thus, this study aimed to assess the effectiveness of 5% LMP and pregabalin in PHN and compare these medications regarding the same. Methods: We searched PubMed, MEDLINE, Google Scholar, EBSCO, and Cochrane Library for publications assessing 5% lidocaine medicated plaster and pregabalin drugs on post-herpetic neuralgia. We included articles published in English from inception up to February 2022. All types of studies were included except case reports, case series, studies on animals, and experimental studies. The terms used were: 5% lidocaine medicated plaster, pregabalin, post-herpetic neuralgia, pain relief, pain reduction, and pain scores. We identified 579 articles and the number stood at 435 after duplication removal, of them, 45 full texts were screened. Eight cohorts from seven studies were included in the final meta-analysis. The most recent RevMan system was used for data analysis. Results: The pain score was significantly lower among patients receiving topical lidocaine compared to placebo or pre and post-intervention (odd ratio, -1.91, 95% CI, -3.77-0.04). Lidocaine Medicated Plaster 5% and pregabalin were effective for pain relief in PHN. However, 5% LMP was more effective (odd ratio, 2.11, 95% CI, 1.41-3.17). Interpretation and Conclusion: Five % lidocaine medicated plaster was effective for the treatment of post-herpetic neuralgia. In addition, the drug was more beneficial than placebo and pregabalin. Further randomized controlled studies assessing the use of LMP 5% on acute herpes zoster and post-herpetic neuralgia are recommended.