BackgroundThis study evaluates the impact of the duration of pre-existing peripheral neuropathic pain on the therapeutic response to the capsaicin 8% cutaneous patch.MethodsThe non-interventional QUEPP (QUTENZA – safety and effectiveness in peripheral neuropathic pain) study evaluated the effectiveness of Qutenza™ in 1044 non-diabetic patients with peripheral neuropathic pain, who received a single application. Follow-up visits were scheduled at weeks 1–2, 4, 8 and 12. A pre-defined co-analysis of changes in average pain intensity was performed based on the duration of pre-existing pain.ResultsIn patients with pre-existing pain for <6 months, the mean relative change of the numeric pain rating scale score on days 7–14 to week 12 versus baseline was −36.6% [4.6 standard error of the mean (SEM); n = 105], −25.1% (1.9 SEM; n = 311) in patients with pain duration of 6 months to 2 years, −22.3% (1.6 SEM; n = 391) in patients with pain for >2–10 years, and −19.2% (2.6 SEM; n = 99) in patients with pain for >10 years. Thirty percent and 50% responder rates were 61.7% and 39.3% in patients with pre-existing pain for <6 months, 42.3% and 23.3% in patients with pain for 6 months to 2 years, 40.9% and 21.6% in patients with pain for >2–10 years, and 32.3% and 14.1% in patients with pain for >10 years.ConclusionsThe highest treatment response to the capsaicin 8% cutaneous patch was observed in patients with a history of pre-existing peripheral neuropathic pain of less than 6 months, suggesting that early initiation of topical treatment might be indicated.
Effective neuropathic pain relief was observed after patch application within the innervation territories of both dorsal and ventral branches of the spinal nerve. Further controlled randomized trials are indicated.
Capsaicin 8 % cutaneous patches seem to be effective and safe for the treatment of post amputation pain, notably in patients suffering from phantom limb pain.
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