Capsaicin 8 % as a cutaneous patch (Qutenza™): analgesic effect on patients with peripheral neuropathic pain

Abstract

Evaluation of the analgesic effect after a single application of the capsaicin 8 % cutaneous patch (Qutenza™) in 37 patients suffering from painful, distal symmetric polyneuropathy (PNP) for an average of 5 years. Patients ranged from 40 to 78 years of age and 22 subjects were HIV-positive. Patients were observed 4 weeks prior to 12 weeks post administration. An evaluation of the therapeutic effect of capsaicin 8 % as a dermal patch in terms of pain reduction, change of sleeping behavior and social activities was performed and statistical analysis of data was conducted using non-parametric methods. Patients were selected according to clinical criteria. Numerical rating scale (NRS 0-10) was used to inquire pain intensity and a pain score was calculated using the painDETECT(©) questionnaire Freynhagen R (Curr Med Res Opin 22:1911-1920, [2006]). A significant reduction of pain was achieved for up to 12 weeks, with a maximum after 2-4 weeks post administration. After patient education and before application of capsaicin patch, a significant reduction of three levels on the NRS was observed. Symptoms of painful PNP decreased over the period of investigation and 8 patients reported a reduction of systemic pain medication. In patients with an HIV infection, a significant extension of sleep was achieved for 2, 4 and 8 weeks after application. Thus, the application of the capsaicin 8 % patch resulted in a significant relief of neuropathic pain, a prolongation of sleep, a reduction of oral pain medication and a resumption of social activities.

Considerable Variability in the Efficacy of 8% Capsaicin Topical Patches in the Treatment of Chronic Pruritus in 3 Patients with Notalgia Paresthetica

“…No other side effects were reported, and the treatment-induced erythema did not evoke secondary hyperpigmentation in any of the subjects. The underlying cause of this noticeable difference in treatment response in NP is unknown, but similar response variation has been observed in the treatment of post-herpetic neuralgia 15 . Of interest, as can be seen in Fig.…”

Short lasting transient effects of a capsaicin 8% patch on nociceptor activation in humans

“…Administration of a capsaicin 8% patch has been applied for painful polyneuropathy and post‐herpetic neuralgia therapy (Backonja et al., ; Simpson et al., ; Clifford et al., ; Irving et al., ; Raber et al., ). Plasma concentration of capsaicin declined below the detection limit within 4.5 h after patch application (Babbar et al., ).…”

Psychophysical and vasomotor evidence for interdependency of TRPA1 and TRPV1-evoked nociceptive responses in human skin: an experimental study

“…It is unclear whether nociceptor activation per se is a crucial aspect of this desensitization process. Some clinical studies have asserted that the use of local anesthetics do not reduce the efficacy of the capsaicin-ablation 44,68,83 . Experimental studies have found an association between the pain experienced during patch application and the efficacy of the desensitization…”