PINE

598 patients, 200 general practitioners, finalised 2004
The Prevention by epidural Injection of postherpetic Neuralgia (PHN) in the Elderly (PINE) study compared the effectiveness and cost-effectiveness of a single epidural injection of local anaesthetics and steroids during acute phase of herpes zoster (HZ) with that of care-as-usual (i.e. antivirals and analgesics) in preventing PHN in elderly patients.
The primary clinical endpoint was the presence of HZ-related pain one month after the onset of the rash. Secondary endpoints included duration and severity of pain, re-interventions aiming to treat the existing pain, side effects, quality of life, and cost-effectiveness.
In this open, multicenter clinical trial, 598 patients older than 50 years with acute phase HZ (rash < 7 days) were randomised to one of the treatment groups.

The Julius Center was responsible for the coordination and execution of the study.

PINE is registered as an International Standard Randomised Controlled Trial, number ISRCTN32866390.

Publications:

van Wijck AJ, Opstelten W, Moons KG, van Essen GA, Stolker RJ, Kalkman CJ, Verheij TJ. The PINE study of epidural steroids and local anaesthetics to prevent postherpetic neuralgia: a randomised controlled trial. Lancet 2006;367(9506):219-24.

Opstelten W, Van Wijck AJ, Van Essen GA, Buskens E, Bak AA, Kalkman CJ, Verheij TJ, Moons KG. The PINE study: rationale and design of a randomised comparison of epidural injection of local anaesthetics and steroids versus care-as-usual to prevent postherpetic neuralgia in the elderly. BMC Anesthesiol. 2004;4(1):2.