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).