457 Systematic Review of the Prevalence of Neuropathic Pain

Gagnon, Angela Mailis; Furlan, Andrea D.; Lakha, S. Fatima; Yegneswaran, Balaji

doi:10.1016/j.ejpain.2007.03.472

Cited by 5 publications

(2 citation statements)

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“…Neuropathic pain (NP), a chronic and disabling condition, affects up to 8% of the European population. [1][2][3] Treatments include tricyclic antidepressants, opioids, anticonvulsants, and topical capsaicin or lidocaine creams. 4,5 Many of these NP medications have limited efficacy, with typically fewer than 50% of patients achieving satisfactory pain relief.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Neuropathic Pain with the Capsaicin 8% Patch: Is Pretreatment with Lidocaine Necessary?

Kern

Nowack

Poole³

2013

Pain Practice

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The capsaicin 8% patch can effectively treat neuropathic pain, but application can cause discomfort or a burning sensation. Until March 2013, it was recommended that patients be pretreated with a topical anesthetic, for example lidocaine, before capsaicin patch application. However, speculation existed over the need for pretreatment and its effectiveness in alleviating treatment-associated discomfort. This article compares tolerability to and efficacy of the capsaicin patch in pretreated and non-pretreated patients. All patients received a single capsaicin patch application. Pretreated patients received a lidocaine plaster before and intravenous lidocaine and metamizole infusions during capsaicin patch application. Pain levels, assessed using a Numeric Rating Scale (NRS), were used to determine tolerability and efficacy. All patients (pretreated n = 32; non-pretreated n = 26) completed 100% of the intended capsaicin patch application duration. At the time of capsaicin patch removal, 69% of pretreated and 88% of non-pretreated patients reported an NRS score increase, which returned to baseline by 6 hours post-treatment. There was no significant difference in mean NRS score between patient groups at any time during or after capsaicin patch treatment. Response was similar between patient groups; capsaicin patch treatment provided rapid and significant pain reductions that were sustained over 12 weeks. The same proportion of pretreated and non-pretreated patients reported willingness to receive retreatment with the capsaicin patch. This analysis shows that the capsaicin 8% patch is generally tolerable, and the small discomfort associated with patch application is short-lived. Lidocaine pretreatment does not have a significant effect on tolerability, efficacy, or patient willingness to receive retreatment.

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Section: Introductionmentioning

confidence: 99%

Treatment of Neuropathic Pain with the Capsaicin 8% Patch: Is Pretreatment with Lidocaine Necessary?

Kern

Nowack

Poole³

2013

Pain Practice

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“…Neuropathic pain is present in 7% of the general population 1,2 , and despite the multiple treatment approaches, its current management only provides modest pain relief 3,4 . There has been renewed interest in the development of topical treatments that can decrease pain with lower side effects 4 .…”

mentioning

confidence: 99%

Liposomal topical capsaicin in post-herpetic neuralgia: a safety pilot study

Teixeira

Menezes

Silva

et al. 2015

Arq. Neuro-Psiquiatr.

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Topical treatments have gained popularity for general use as an adjunct to systemic drugs in neuropathic pain, but their use produces variable clinical results and local adverse events. Objective: To evaluate the safety and analgesic effect of a formulation of liposomal capsaicin (LC) (0.025%) in patients with post herpetic neuralgia (PHN). Method: Patients who remained symptomatic after first-and second-line treatment were randomized to receive LC for six weeks in a placebo-controlled, crossover design study. Clinical assessment was performed at baseline, in the second, fourth and sixth week of treatment. Results: Thirteen patients completed both treatment periods. Visual Analog Scale (VAS) was significantly decreased after the end of the study (p = 0.008), however the effect of treatment was not significant (p = 0.076). There was no difference on global impression of change and other pain characteristics. LC was safe and well tolerated. However, at the concentration used, its analgesic effects were marginal and not significant.Keywords: capsaicin, pain, neuralgia, analgesia, rash, adverse events. RESUMOOs tratamentos tópicos ganharam popularidade para uso geral como um adjuvante de medicamentos sistêmicos na dor neuropática, mas seu uso produz resultados clínicos variáveis e eventos adversos locais. Objetivo: Avaliar o efeito de segurança e analgesia de uma formulação de capsaicina lipossomal (LC) (0,025%) em pacientes com neuralgia pós-herpética. Método: Os pacientes que permaneceram sintomáticos após tratamento de primeira e de segunda linha foram randomizados para receber LC durante seis semanas em um estudo cruzado controlado por placebo. A avaliação clínica foi realizada no início do estudo, na segunda, quarta e sexta semana de tratamento. Resultados: Treze pacientes completaram dois períodos de tratamento. Escala Visual Analógica diminuiu significativamente após o final do estudo (p = 0,008), no entanto, o efeito do tratamento não era significativo (p = 0,076). Não houve diferença na impressão global de mudança e de outras características da dor. LC foi segura e bem tolerada. No entanto, para a concentração utilizada, os seus efeitos analgésicos foram marginais e não significativos.Palavras-chave: capsaicina, dor, neuralgia, analgesia, efeitos adversos.Neuropathic pain is present in 7% of the general population 1,2 , and despite the multiple treatment approaches, its current management only provides modest pain relief 3,4 . There has been renewed interest in the development of topical treatments that can decrease pain with lower side effects 4 . However, the use of topical treatments has provided variable analgesic results 5,6 and is associated with side effects mainly related to skin reactions and pain in the application site 7,8 . One approach to increase the therapeutic index (i.e., the measurement of efficacy over toxicity) is to employ delivery systems that can release the medication to its target with fewer side effects related to local inflammation 9 . Topical capsaicin has been used in th...

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The Capsaicin 8% Patch for Neuropathic Pain in Clinical Practice: A Retrospective Analysis

Wagner¹,

Poole

Roth-Daniek³

2013

Pain Med

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ObjectiveTo investigate the response of patients with peripheral neuropathic pain (PNP) to capsaicin 8% patch treatment in a clinical setting.DesignRetrospective analysis.SettingThe Clinic for Pain Therapy and Palliative Medicine at the Medical Centre for the region of Aachen, Germany.SubjectsPatients diagnosed with PNP who attended the clinic for capsaicin 8% patch treatment between January 13, 2010 and February 7, 2011.Outcome MeasuresPain intensity was assessed using the Numeric Pain Rating Scale (NPRS) at baseline and following each capsaicin 8% patch treatment. Changes in prescribed concomitant neuropathic pain (NP) medications and response duration were recorded.ResultsOverall, 68 patients with PNP conditions, including facial neuropathy (severe trigeminal neuralgia in V2), polyneuropathy, post-herpetic neuralgia, and mononeuropathies, received 96 treatments with the capsaicin 8% patch. The 53 patients with a follow-up of ≥8 weeks demonstrated a 48.4% mean reduction in NPRS score from baseline to Weeks 1–8. Among the 37 responders (those exhibiting ≥30% reduction in NPRS score from baseline to Weeks 1–8), the median time to re-treatment was 125 days. Following treatment, there was a significant (P < 0.001) 54% reduction in the mean number of prescribed concomitant NP medications taken by patients.ConclusionsThis analysis demonstrates that in clinical practice, the capsaicin 8% patch provides rapid and sustained pain reductions in patients with a variety of PNP conditions and a significant reduction in prescribed concomitant NP medications. The capsaicin 8% patch can be a valuable addition to the NP treatment armory for certain patients.

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457 Systematic Review of the Prevalence of Neuropathic Pain

Cited by 5 publications

References 0 publications

Treatment of Neuropathic Pain with the Capsaicin 8% Patch: Is Pretreatment with Lidocaine Necessary?

Treatment of Neuropathic Pain with the Capsaicin 8% Patch: Is Pretreatment with Lidocaine Necessary?

Liposomal topical capsaicin in post-herpetic neuralgia: a safety pilot study

The Capsaicin 8% Patch for Neuropathic Pain in Clinical Practice: A Retrospective Analysis

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