Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients.

Ellison, Neil M.; Loprinzi, Charles L.; Kugler, John W.; Hatfield, Alan K.; Miser, Angela W.; Sloan, Jeff A.; Wender, Donald B.; Rowland, Kendrith M.; Molina, R.; Cascino, Terrence L.; Vukov, Allen M.; Dhaliwal, Harbhajan; Ghosh, Chirantan

doi:10.1200/jco.1997.15.8.2974

Cited by 152 publications

(88 citation statements)

References 21 publications

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“…When applied topically, it causes the depolarization of the nociceptors and release of substance P. Regular use eventually leads to depletion of substance P from the terminals of afferent C-fibers, potentially leading to decreased pain perception. In cancer patients, capsaicin cream (Zostrix ® ; Rodlen Laboratories; Vernon Hills, IL) has been shown to be effective in reducing neuropathic postsurgical pain (such as postmastectomy pain) [104]. There are two commercially available concentrations (0.025% and 0.075%), and an initial trial usually involves application of the higher concentration three to four times daily.…”

Section: Topical Analgesicsmentioning

confidence: 99%

Adjuvant Analgesics in Cancer Pain Management

2004

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Adjuvant analgesics are defined as drugs with a primary indication other than pain that have analgesic properties in some painful conditions. The group includes numerous drugs in diverse classes. Although the widespread use of these drugs as first-line agents in chronic nonmalignant pain syndromes suggests that the term "adjuvant" is a misnomer, they usually are combined with a less-than-satisfactory opioid regimen when administered for cancer pain. Some adjuvant analgesics are useful in several painful conditions and are described as multipurpose adjuvant analgesics (antidepressants, corticosteroids, α α 2 -adrenergic agonists, neuroleptics), whereas others are specific for neuropathic pain (anticonvulsants, local anesthetics, N-methyl-D-aspartate receptor antagonists), bone pain (calcitonin, bisphosphonates, radiopharmaceuticals), musculoskeletal pain (muscle relaxants), or pain from bowel obstruction (octreotide, anticholinergics). This article reviews the evidence supporting the use of each class of adjuvant analgesic for the treatment of pain in cancer patients and provides a comprehensive outline of dosing recommendations, side effects, and drug interactions. The Oncologist 2004;9:571-591

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Section: Topical Analgesicsmentioning

confidence: 99%

Adjuvant Analgesics in Cancer Pain Management

2004

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“…Topical application of capsaicin has been used in cancer patients in the management of long-term neuropathic pain resulting from surgery (43). Patients received 8 weeks of a 0.075% capsaicin cream (4 times per day) followed by 8 weeks of an identical-looking placebo cream or vice versa.…”

Section: The Paradox Of Topical Application Of Capsaicinmentioning

confidence: 99%

The Two Faces of Capsaicin

2011

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Capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide) is the principal pungent component in hot peppers, including red chili peppers, jalapeños, and habaneros. Consumed worldwide, capsaicin has a long and convoluted history of controversy about whether its consumption or topical application is entirely safe. Conflicting epidemiologic data and basic research study results suggest that capsaicin can act as a carcinogen or as a cancer preventive agent. Capsaicin is unique among naturally occurring irritant compounds because the initial neuronal excitation evoked is followed by a long-lasting refractory period, during which the previously excited neurons are no longer responsive to a broad range of stimuli. This process is referred to as desensitization and has been exploited for its therapeutic potential. Capsaicin-containing creams have been in clinical use for many years to relieve a variety of painful conditions. However, their effectiveness in pain relief is also highly debated and some adverse side effects have been reported. We have found that chronic, long-term topical application of capsaicin increased skin carcinogenesis in mice treated with a tumor promoter. These results might imply that caution should be exercised when using capsaicin-containing topical applications in the presence of a tumor promoter, such as, for example, sunlight. Cancer Res; 71(8);

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“…5 Capsaicin is also used to induce cell-cycle arrest or apoptosis or inhibit cell proliferation in a variety of cancer cells. 6 Some capsaicin containing creams are used for the treatment of painful conditions such as long-term neuropathic pain in cancer patients 7 and diabetic neuropathy. 8 The quantity of active compounds depends on several factors such as intra species variability, environmental conditions, geographical variations, harvesting and storage time and extraction methods.…”

Section: Introductionmentioning

confidence: 99%

Validation of Capsaicin in Indian Capsicum Species Through RP-HPLC

Nag¹,

Chanda²,

Biswas³

et al. 2017

IJPER

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Capsaicin is a pungent capsacinoid which differs in capsicum fruit within the species and the cultivars due to its topographical diversity. Here, a comparative estimation of capsaicin in seven varieties of capsicum has been performed by RP-HPLC method. The method was carried out in reverse phase C 18 column using acetonitrile and water (1% acetic acid) as mobile phase (65:35 v/v), at the flow rate of 1ml/min. The λmax was detected at 230 nm. The calibration curves were linear in the concentration range of 1-80 µg/ml. The comparative study revealed that the capsaicin content was highest (3.12% w/w) in Capsicum annuum Cayenne whereas Capsicum cardenasii contains the lowest (0.85% w/w). The % RSD of precision and recovery was found to be < 2%, which confirms high repeatability of the method. This method can be commercialized at industrial level for ensuring the highest quality of capsicum used as raw material.

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Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients.

Abstract: A topical capsaicin cream decreases postsurgical neuropathic pain and, despite some toxicities, is preferred by patients over a placebo by a three-to-one margin among those expressing a preference.

Cited by 152 publications

References 21 publications

Adjuvant Analgesics in Cancer Pain Management

Adjuvant Analgesics in Cancer Pain Management

The Two Faces of Capsaicin

Validation of Capsaicin in Indian Capsicum Species Through RP-HPLC

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