What role for capsaicin in diabetic peripheral neuropathy?

doi:10.1136/dtb.2016.8.0417

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…This is thought to desensitize afferent Aδ and C fibers [55]. Two forms of capsaicin are available for the treatment of painful DSPN: a low-dose cream (0.075%) [31] and a high-dose (8%) patch (Qutenza, Acorda Therapeutics, Ardsley, NY, USA) [56]. A series of studies have provided evidence of pain relief among subjects who received capsaicin cream in comparison to the vehicle [57][58][59][60], although results were inconsistent [61][62][63].…”

Section: Topical Treatmentmentioning

confidence: 99%

Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

et al. 2020

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Background and Objectives: Distal symmetrical polyneuropathy (DSPN) is one of the most common chronic complications of diabetes mellitus. Although it is usually characterized by progressive sensory loss, some patients may develop chronic pain. Assessment of DSPN is not difficult, but the biggest challenge is making the correct diagnosis and choosing the right treatment. The treatment of DSPN has three primary objectives: glycemic control, pathogenic mechanisms, and pain management. The aim of this brief narrative review is to summarize the current pharmacological treatment of painful DSPN. It also summarizes knowledge on pathogenesis-oriented therapy, which is generally overlooked in many publications and guidelines. Materials and Methods: The present review reports the relevant information available on DSPN treatment. The search was performed on PubMed, Cochrane, Semantic Scholar, Medline, Scopus, and Cochrane Library databases, including among others the terms “distal symmetrical polyneuropathy”, “neuropathic pain treatment”, “diabetic neuropathy”, “diabetes complications”, ”glycaemic control”, “antidepressants”, “opioids”, and “anticonvulsants”. Results: First-line drugs include antidepressants (selective serotonin reuptake inhibitors and tricyclic antidepressants) and pregabalin. Second- and third-line drugs include opioids and topical analgesics. While potentially effective in the treatment of neuropathic pain, opioids are not considered to be the first choice because of adverse reactions and addiction concerns. Conclusions: DSPN is a common complication in patients with diabetes, and severely affects the quality of life of these patients. Although multiple therapies are available, the guidelines and recommendations regarding the treatment of diabetic neuropathy have failed to offer a unitary consensus, which often hinders the therapeutic options in clinical practice.

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Section: Topical Treatmentmentioning

confidence: 99%

Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

et al. 2020

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“…Repeated TRPV1 exposure to capsaicin causes substance P depletion and TRPV1 desensitization and defunctionalization (7). Two forms of capsaicin are available for DNP, a low-dose cream and a high-dose patch, both of which should be used under specialist supervision (67). Capsaicin creams with concentrations of 0.025–0.250% must be applied multiple times per day for several weeks before analgesic effects become obvious (68).…”

Section: Topical Pharmacological Treatment Of Dnpmentioning

confidence: 99%

“…Compared with SOC therapy alone, SOC plus capsaicin 8% patch repeat treatment over 52 weeks was well tolerated, had no neurological or negative functional effects and raised no new safety concerns (77). An article from the Drug and Therapeutics Bulletin proposed that there is a limited role for topical capsaicin in the treatment of DNP due to the uncertain efficacy of low-concentration topical capsaicin and the considerably more expensive cost of the 8% capsaicin patch compared with oral therapies (67). However, topical 0.075% capsaicin was recommended as a likely effective treatment option for DNP in the American Academy of Neurology evidence-based guidelines (78).…”

Section: Topical Pharmacological Treatment Of Dnpmentioning

confidence: 99%

Topical treatments for diabetic neuropathic pain (Review)

et al. 2019

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Diabetic neuropathic pain (DNP) has a huge impact on quality of life and can be difficult to treat. Oral treatment is the most frequently used method for DNP, but its use is often limited by systemic side effects. Topical use of drugs as an alternative option for DNP treatment is currently gaining interest. In the present review, a summary is provided of the available agents for topical use in patients with DNP, including lidocaine plasters or patches, capsaicin cream, gel or patches, amitriptyline cream, clonidine gel, ketamine cream, extracts from medicinal plants including nutmeg extracts and Citrullus colocynthis extract oil, and certain compounded topical analgesics. Furthermore, the potential efficacy of these treatments is addressed according to the available clinical research literature. It has been indicated that these topical drugs have the potential to be valuable additional options for the management of DNP, with adequate safety and continuous long-term treatment efficacy. Compounded topical agents are also effective and safe for patients with DNP and could be another area worthy of further investigation based on the strategy of using low-dose, complementary therapies for DNP. The findings indicate that developing topical drugs acting on different targets in the process of DNP is a valuable area of future research.

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The Role of the Capsaicin 8% Patch in the Treatment of Painful Diabetic Peripheral Neuropathy

Leavell

Simpson

2022

Pain Manag.

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Treatment of painful diabetic peripheral neuropathy (PDPN) is challenging and often limited by drug tolerability and adverse effects. This review article focuses on the high-dose (8%) capsaicin patch that allows for improved efficacy and reduced application frequency in comparison to low-dose capsaicin formulations. Systemic absorption is minimal resulting in fewer systemic side effects than first-line oral medications. There is evidence that capsaicin patch treatment is well-tolerated, safe and provides effective pain relief maintained for several weeks; well-powered studies are needed to confirm these findings. The capsaicin 8% patch may benefit patients at high risk for adverse effects from oral medication, polypharmacy or inadequate pain relief from first-line therapies.

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What role for capsaicin in diabetic peripheral neuropathy?

Cited by 3 publications

References 15 publications

Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

Topical treatments for diabetic neuropathic pain (Review)

The Role of the Capsaicin 8% Patch in the Treatment of Painful Diabetic Peripheral Neuropathy

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