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In patients with no
initial response, the capsaicin 179 mg topical patch when used repeatedly can
offer pain relief due to neuropathy.
According to a novel study in Pain medicine journal exploring the
effectiveness of repeated capsaicin 179 mg (8%
w/w) cutaneous patch usage, some patients with neuropathic
pain may need 2-3 therapies
before an initial response.
This 52-week post hoc analysis of 2 prospective trials
(STRIDE trial comprising of non-diabetic neuropathic pain patients and PACE
trial comprising of patients with painful diabetic peripheral neuropathy) was
performed by Rainer
Freynhagen and investigators.
The patients were stratified in accordance with the
number of applications required before ≥30% response on average pain intensity
(Brief Pain Inventory [BPI-Q5]).
In the trial under
consideration, 306 out of 313 patients received capsaicin patch. 60 out of 96
patients had a response following the first use, 33 out of 68 patients
following the second, 11 out of 43 patients following the third. In patients with no ≥ 30% decrease in pain intensity within first 3
months, 23.3% out of 28.1% attained a this decrease at 6 months, escalating to
33.9% out of 45.7% at 12 months. A
reduction of ≥ 50% as responder definition had similar outcomes.
At 1 year, gradual
improvements in pain intensity in slower responders achieved similar levels as
those in early responders along with improvements in sleep (mean 'interference
with sleep' score), quality of life via EuroQol 5-dimension, and patient
satisfaction (Self-Assessment of Treatment questionaire).
Pain medicine
Progressive Response to Repeat Application of Capsaicin 179 mg (8% w/w) Cutaneous Patch in Peripheral Neuropathic Pain: Comprehensive New Analysis and Clinical Implications
Rainer Freynhagen et al.
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