A Cochrane review included 5 studies with a total of 787 subjects. There was no significant difference between the corticosteroid and control groups for the primary outcome, the presence of postherpetic neuralgia six months after the onset of the acute herpetic rash (RR 1.27, 95% CI 0.20 to 7.97). There was also no significant difference between the corticosteroid plus antiviral agents and placebo plus antiviral agents groups for the primary outcome (RR 0.90, 95% CI 0.40 to 2.03). A meta-analysis of two trials (n=114) showed that oral corticosteroids did not prevent postherpetic neuralgia 6 months after the herpes onset (RR 0.95; 95% CI 0.45 to 1.99). There was no significant difference in any adverse events.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by indirectness (differences in studied interventions, wide time range of the included studies).