High concentration capsaicin for treatment of peripheral neuropathic pain: effect on somatosensory symptoms and identification of treatment responders

Höper, Johanna; Helfert, Stephanie; Heskamp, Marie-Luise S.; Maihöfner, Christian; Baron, Ralf

doi:10.1185/03007995.2013.869491

Cited by 32 publications

(23 citation statements)

References 20 publications

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“…Moreover, data from a large uncontrolled general prediction study of high-concentration capsaicin patches showed that higher baseline painDETECT scores were associated with greater pain reduction after 12 weeks of treatment in patients with chronic neuropathic pain [126]. Collectively, these findings strongly suggest that specific neuropathic pain phenotypes may be associated with differential responses to varying analgesic treatments.…”

Section: Phenotypic Domainsmentioning

confidence: 99%

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

Edwards

Dworkin

Turk

et al. 2016

Pain

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There is tremendous inter-patient variability in the response to analgesic therapy (even for efficacious treatments), which can be the source of great frustration in clinical practice. This has led to calls for “precision medicine”, or personalized pain therapeutics (i.e., empirically-based algorithms that determine the optimal treatments, or treatment combinations, for individual patients) that would presumably improve both the clinical care of patients with pain, and the success rates for putative analgesic drugs in Phase 2 and 3 clinical trials. However, before implementing this approach, the characteristics of individual patients or subgroups of patients that increase or decrease the response to a specific treatment need to be identified. The challenge is to identify the measurable phenotypic characteristics of patients that are most predictive of individual variation in analgesic treatment outcomes, and the measurement tools that are best suited to evaluate these characteristics. In this article, we present evidence on the most promising of these phenotypic characteristics for use in future research, including psychosocial factors, symptom characteristics, sleep patterns, responses to noxious stimulation, endogenous pain-modulatory processes, and response to pharmacologic challenge. We provide evidence-based recommendations for core phenotyping domains and recommend measures of each domain.

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Section: Phenotypic Domainsmentioning

confidence: 99%

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

Edwards

Dworkin

Turk

et al. 2016

Pain

Self Cite

306

261

View full text Add to dashboard Cite

show abstract

“…Höper et al [12] evaluated sensory neuropathic abnormalities (painDETECT questionnaire), finding that the presence of burning and pressure-evoked pain was weakly associated with treatment response. They argued that thermal hyperalgesia is difficult to interpret and thus cannot serve as a predictor of response, which could be ascribed to the fact that the painDETECT questionnaire does not distinguish between cold and heat-evoked pain.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Thermal Testing Profiles as a Predictor of Treatment Response to Topical Capsaicin in Patients with Localized Neuropathic Pain

Serrano

Torres

Veciana

et al. 2017

Pain Research and Treatment

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There are no reliable predictors of response to treatment with capsaicin. Given that capsaicin application causes heat sensation, differences in quantitative thermal testing (QTT) profiles may predict treatment response. The aim of this study was to determine whether different QTT profiles could predict treatment outcomes in patients with localized peripheral neuropathic pain (PeLNP). We obtained from medical records QTT results and treatment outcomes of 55 patients treated between 2010 and 2013. Warm sensation threshold (WST) and heat pain threshold (HPT) values were assessed at baseline at the treatment site and in the asymptomatic, contralateral area. Responders were defined as those who achieved a > 30% decrease in pain lasting > 30 days. Two distinct groups were identified based on differences in QTT profiles. Most patients (27/31; 87.1%) with a homogenous profile were nonresponders. By contrast, more than half of the patients (13/24, 54.2%) with a nonhomogenous profile were responders (p = 0.0028). A nonhomogenous QTT profile appears to be predictive of response to capsaicin. We hypothesize patients with a partial loss of cutaneous nerve fibers or receptors are more likely to respond. By contrast, when severe nerve damage or normal cutaneous sensations are present, the pain is likely due to central sensitization and thus not responsive to capsaicin. Prospective studies with larger patient samples are needed to confirm this hypothesis.

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“…The experimental drug improved the NRS scores significantly, but the results regarding the PD-Q scores were not reported. Another open-label study on patients with NeP [15] used the PD-Q not only to identify NeP components (consequently, 18.3% of the patients had low PD-Q scores [<13]) but also to evaluate its severity. However, that study also did not present the results of the PD-Q scores over time, because completion of the PD-Q was optional in that study.…”

Section: Discussionmentioning

confidence: 99%

“…These correlations were also observed in the subset of 35 patients with a high PD-Q score (≥ 13) (current pain, r=0.38, p=0.03; average pain in the past 4 weeks, r=0.53, p=0.001; worst pain in the past 4 weeks, r=0.28, p=0.098). However, the and secondary endpoints [8][9][10][11][12][13]15]. The patients were asked to complete them twice.…”

Section: Methodsmentioning

confidence: 99%

“…The PD-Q seems to reliably distinguish the severity of pain in patients with NeP [14]; however, it has not yet been validated whether the changes of the PD-Q score can follow changes of pain severity assessed using the NRS in both the high and low PD-Q score subsets. In fact, one of the largest longitudinal observational studies on a drug treatment demonstrated significant improvement in NRS scores but not in the PD-Q scores [15]. In the present study, we examined whether the PD-Q score reflected pain intensity and could be used to track the course of pain symptoms over time in both patients with NeP components (i.e., PD-Q score ≥ 13) and without NeP components (i.e., PD-Q score <13).…”

Section: International Journal Of Anesthesiology and Pain Medicine Issnmentioning

confidence: 99%

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Validation of Pain Severity Assessment using the PainDETECT Questionnaire

Sumitani¹,

Matsubayashi²,

Tsuchida³

et al. 2017

Int J Anesth Pain Med

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show abstract

High concentration capsaicin for treatment of peripheral neuropathic pain: effect on somatosensory symptoms and identification of treatment responders

Abstract: Completion of painDETECT was optional and therefore data was not available for all patients. Further studies for confirmation of these results are needed.

Cited by 32 publications

References 20 publications

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

Quantitative Thermal Testing Profiles as a Predictor of Treatment Response to Topical Capsaicin in Patients with Localized Neuropathic Pain

Validation of Pain Severity Assessment using the PainDETECT Questionnaire

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