Cobratide Injection Shows Comparable Pain Relief to Pregabalin in Herpes Zoster: Study
Researchers have found in a recent study that Cobratide injection produced a similar degree of pain reduction as Pregabalin in herpes zoster, while demonstrating a favorable tolerability profile. The findings suggest that Cobratide may be a promising alternative for pain management. However, the researchers emphasized that larger, adequately powered clinical trials are needed to confirm its efficacy and safety before broader clinical adoption. The study was published in Journal of the American Academy of Dermatology by Xuegang Xu and colleagues.
In order to create a thorough comparison of this innovative peptide injection and traditional medication in terms of its effectiveness and safety, researchers have conducted a multi-centered randomized, double-blind, double-dummy, parallel-group controlled, exploratory clinical trial. The trial recruited a total of 80 patients aged 50 to 70 years suffering from clinically diagnosed moderate-to-severe acute herpes zoster neuralgia. Participants who met the requirements were randomized on a 1:1 ratio to receive either active Cobratide intramuscular injection combined with oral placebo, or active pregabalin capsules taken orally alongside with a sham injection.
The comparative treatment course lasted for 28 days. The key criterion of efficacy used in the study is the change in NRS pain score from the baseline to day 28. As an exploratory study aimed at collecting preliminary information on the safety and efficacy of the drug, no sample size calculation was conducted prior to the initiation of the trial. The development of postherpetic neuralgia was considered a secondary outcome of interest to be evaluated at the week 12 follow-up point. All other secondary outcomes were the occurrence of treatment emergent adverse events (TEAEs).
Key findings:
- The exploratory multicenter randomized clinical trial managed to randomize an aggregate sample size of 80 adult patients suffering from severe shingles neuralgia.
- The patients were equally distributed among the groups as per the planned design with 40 patients being randomized for the intramuscular Cobratide treatment and 40 patients randomized for the oral pregabalin treatment.
- On the 28-day mark, reduction in average NRS pain scores by least squares mean were documented to be 6.00 points for those on the active Cobratide injections, which is quite similar to the 5.63 points reduction in the oral pregabalin group.
- The difference between the two groups in terms of pain relief efficacy was measured to be just 0.37 points.
- This proves that there is no statistically significant difference between the two in terms of potency (P = 0.186).
- Postherpetic neuralgia was observed to occur in 0 out of 27 evaluable patients in the Cobratide group and 3 out of 27 evaluable patients in the pregabalin group (P = 0.236).
- Overall treatment-emergent adverse events occurred in only 35.9% of patients on Cobratide injections compared to 51.2% of patients on pregabalin treatments.
In summary, Cobratide administration exhibited a comparable degree of analgesia to Pregabalin while showing good tolerability.
Reference:
Xu, X., Han, X., Li, X., Chen, L., Li, C., Ma, L., Ji, M., Zhang, Y., Chen, H., Wang, X., Wang, Q., & Gao, X. (2026). Cobratide injection vs pregabalin for moderate-to-severe acute herpes zoster neuralgia: A randomized, double-blind, double-dummy, active-controlled, multicenter exploratory trial. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2026.06.062
