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

Wagner, Till; Poole, Chris; Roth-Daniek, Andrea

doi:10.1111/pme.12143

Cited by 42 publications

(22 citation statements)

References 23 publications

(50 reference statements)

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“…Separate analyses of 58 patients from the clinic in Wiesbaden and 68 patients from Aachen have shown that 100% of patients completed the intended duration of patch application [21,22]. It was also observed that by 6 h after the initiation of capsaicin 8% patch treatment, any increase in pain scores owing to application of the patch had returned to pretreatment baseline levels [21].…”

Section: Management Of Treatment-related Discomfort and Tolerability Ofmentioning

confidence: 93%

“…Many of the patients receiving capsaicin 8% patch treatment without topical anesthetic pretreatment received no analgesic medication, including no prophylactic medications, other than cooling measures after treatment. Some patients received intravenous nonsteroidal antiinflammatory analgesics; in a very few cases, patients were treated with intravenous opioids [21,22]. However, all patients completed ≥90% of the intended patch application duration.…”

Section: Requirement For Topical Anesthesia Before Patch Applicationmentioning

confidence: 98%

“…At the clinic in Aachen, 67% of patients with PHN and 70% of patients overall responded (exhibited ≥30% decrease in pain levels) to treatment with the capsaicin 8% patch [22] compared with 42 or 46% of patients with PHN in two separate studies [9,10] and 34% of patients with HIV-DSP [8]. In a further trial of patients with HIV-DSP, 38% of patients treated for 30 min with the capsaicin 8% patch exhibited a ≥30% decrease in pain levels, although this was not significantly different from the proportion of patients treated with a control patch achieving a ≥30% decrease in pain levels [34].…”

Section: Real-life Experience With Capsaicin 8% Patch Treatment Compamentioning

confidence: 99%

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Capsaicin 8% Patch for Peripheral Neuropathic Pain: Review of Treatment Best Practice from ‘Real-World‘ Clinical Experience

Wagner¹,

Roth-Daniek²,

Sell

et al. 2012

Pain Manage.

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SUMMARY The capsaicin 8% patch is licensed in Europe for the treatment of peripheral neuropathic pain in nondiabetic adults. In controlled trials it provided pain relief for up to 3 months with a single 30- or 60-min application. In this article, a group of pain specialists from Germany and the UK share their considerable experience of real-world use of the capsaicin 8% patch. This experience comes from treating >200 patients with a variety of neuropathic pain etiologies including postherpetic neuralgia, peripheral neuropathy and cancer-related neuropathy. These patients, a slight majority of whom were female, had experienced neuropathic pain for varied lengths of time (3 months to >15 years) and the majority were receiving concomitant medications for their pain at the time of capsaicin 8% patch treatment. Observations by the group suggest that patients with positive symptoms might respond best to therapy. To optimize response to treatment, the group reports that it is important to achieve good adhesion of the patch to the skin. The experience of the group is that the capsaicin 8% patch is a tolerable treatment and local anesthetic pretreatment may not always be required. Cooling measures used after treatments were found to be the most practical and beneficial means of relieving any treatment-related discomfort. The group observed that transient, clinically important increases in blood pressure owing to treatment-related discomfort are very rare and they have seen no correlation between treatment-related discomfort or erythema and response to treatment. In the real-life clinical setting, response to capsaicin 8% patch treatment may be higher than observed in the clinical trial program. Response to retreatment also appears to be equal to that of the first treatment, even in patients treated for the fifth time. It was also observed that patients receiving capsaicin 8% patch treatment are often able to reduce their intake of concomitant pain medications. Observations from real-life use of the capsaicin 8% patch will help to maximize its therapeutic potential.

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Section: Management Of Treatment-related Discomfort and Tolerability Ofmentioning

confidence: 93%

Section: Requirement For Topical Anesthesia Before Patch Applicationmentioning

confidence: 98%

Section: Real-life Experience With Capsaicin 8% Patch Treatment Compamentioning

confidence: 99%

See 1 more Smart Citation

Capsaicin 8% Patch for Peripheral Neuropathic Pain: Review of Treatment Best Practice from ‘Real-World‘ Clinical Experience

Wagner¹,

Roth-Daniek²,

Sell

et al. 2012

Pain Manage.

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“…Topical capsaicin is thought to act by attenuating a hypersensitivity response in the skin that reduces nociception through TRPV1 desensitization, a process known as defunctionalization, which includes a temporary loss of membrane potential, a loss of membrane transport capabilities, and a retraction of epidermal and dermal nerve fiber endings [20, 21]. Capsaicin-mediated defunctionalization of TRPV1 has been shown to be effective in the treatment of neuropathic pain [22]. Routine use of capsaicin analgesics is hampered by burning and painful sensations upon first use.…”

Section: Transient Receptor Potential Cation Channel (Trp) Pharmacmentioning

confidence: 99%

Pain transduction: a pharmacologic perspective

McEntire

Kirkpatrick

Dueck

et al. 2016

Expert Review of Clinical Pharmacology

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Pain represents a necessary physiological function yet remains a significant pathological process in humans across the world. The transduction of a nociceptive stimulus refers to the processes that turn a noxious stimulus into a transmissible neurological signal. This involves a number of ion channels that facilitate the conversion of nociceptive stimulus into an electrical signal. Because an understanding of nociceptive physiology complements a discussion of analgesic pharmacology, the relationships between the two are presented together. In this review article, a critical evaluation is provided on the findings relating to both the physiology and pharmacology of relevant acid-sensing ion channels (ASIC), and transient receptor potential (TRP) cation channels, and voltage-gated sodium (Nav) channels.

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“…Capsaicin (Qutenza) 8% (concentrated extract of chili peppers) is an interesting and more potent drug in comparison with capsaicin 0.025% and is usually effective (sometimes works where nothing else works) (36). Wagner et al addressed the effect of inter-costal nerve blocks with local anesthetic and corticosteroids on ICN injuries and indicated the positive response to this approach; he recommended radiofrequency pulse (36). Stellate ganglion block is another recommended therapy for PMPS that results in cervical sympathetic trunk block or vertebral ganglion, postganglionic and pre-ganglionic fibers, inferior cervical sympathetic ganglia, and thoracic sympathetic ganglia (13,37,38).…”

Section: Treatmentmentioning

confidence: 99%