Capsaicin 8% Patch Repeat Treatment in Nondiabetic Peripheral Neuropathic Pain

Abstract

Generally, capsaicin 8% patch repeat treatment over 52 weeks was well tolerated, with variable alteration in sensory function and minimal chance of complete sensory loss.

Capsaicin and Gut Microbiota in Health and Disease

“…CAP and the related nonpungent capsinoids (capsiate, dihydrocapsiate, nordihydrocapsiate) have been proven to elicit analgesic, antioxidant, anti-inflammatory, anticarcinogenic, weight modulatory, cardio-protective, anti-lithogenic, and circadian-modulatory effects [4]. Therefore, besides its culinary utilization, CAP has been used as a therapeutic agent in various painful chronic conditions, such as those encountered in diabetic and nondiabetic neuropathy, temporo-mandibular joint disorder, burning mouth syndrome, postherpetic neuralgia, osteoarthritis, or rheumatoid arthritis [1,[5][6][7]. On the other hand, there are data showing that chronic exposure to high doses of CAP can enhance the development of liver, stomach, duodenal, and prostate cancer, and can induce peptic ulcers [1,8,9].…”

The use of high dose topical capsaicin in the management of peripheral neuropathy: narrative review and local experience

“…Of these, one publication was a randomised, double blind, placebocontrolled trial by Simpson et al 18 Details regarding seven of the publications are summarised in Table 1. [18][19][20][21][22][23][24] One paper by Filipczak-Bryniarska et al 25 has not been included, as it reports a single-centre experience of 8% capsaicin therapy in 18 patients with oxaliplatininduced neuropathy. The Simpson et al 18 publication gives further evidence to the efficacy of 8% capsaicin in the management of painful diabetic peripheral neuropathy and would be a useful addition to further systematic review and meta-analysis.…”

“…They mimic, or in two instances collect data from, clinical practice where repeated applications are potentially necessary. [21][22][23][24] These publications highlight important data about the relative tolerability of repeated therapy and the lack of neuronal damage from repeated applications that could cause neurological deficits that impact on an individuals' function. In addition, a national, longitudinal, post-marketing surveillance study of 684 non-diabetic patients with peripheral neuropathy demonstrated treatment success in 21.8% of participants in the 6 months following the individuals last application (of which they could have had between 1 and 5 topical 8% capsaicin treatments) based on a >30% numerical pain rating scale reduction and improvements in patients global impression of change scores which support the studies examining repeated use.…”

Novel Insights on the Management of Pain: Highlights From the ‘Science of Relief’ Meeting

“…The capsaicin 8% patch has proved to be an effective and safe treatment in several clinical trials and 'field-practice' studies, for multiple painful neuropathy conditions [50][51][52][53][54][55][56][57][58][59][60][61][62]. In the recent randomized ELEVATE study, conducted in more than 500 patients with peripheral neuropathic pain, the capsaicin 8% patch was shown to be noninferior to pregabalin for a ≥30% mean decrease of the pain score on a numeric pain rating scale (from baseline to week 8 [55.7 vs 54.5%; OR: 1.03 [95% CI: 0.72-1.50]) [58].…”