The Effects of Capsaicin on the Neurogenic Hyperreflexic Detrusor. A Double Blind Placebo Controlled Study in Patients With Spinal Cord Disease. Preliminary Results

Wiart, L.; Joseph, PA; Petit, H; Dosque, Jean-Pierre; Saze, M. de; Brochet, Bruno; Déminière, C.; Ferrière, J.; Mazaux, Jean-Michel; Nguyen, P.; Barat, M.

doi:10.1016/s0022-5347(01)62342-5

Cited by 9 publications

(26 citation statements)

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“…In a double‐blind placebo‐controlled trial comprised of 20 patients with spinal cord injury with NDO, intravesical instillation of 30 mg capsaicin dissolved in 30% ethanol resulted in a significant improvement in clinical and urodynamic parameters, with a significant decrease in 24‐h voiding frequency and maximum detrusor pressure and an increase in maximum cystometric capacity . Similar results were obtained in another RCT, although at the expense of significant initial side‐effects, including burning pelvic pain, sensory urgency, flushes, haematuria and autonomic hyperreflexia . Using capsaicin dissolved in glucidic solvent instead of ethanol had similar short‐term efficacy in patients with NDO with better tolerance after the instillation .…”

Section: Trpv1supporting

confidence: 76%

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Transient receptor potential channel modulators as pharmacological treatments for lower urinary tract symptoms (LUTS): myth or reality?

et al. 2015

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Transient receptor potential (TRP) channels belong to the most intensely pursued drug targets of the last decade. These ion channels are considered promising targets for the treatment of pain, hypersensitivity disorders and lower urinary tract symptoms (LUTS). The aim of the present review is to discuss to what extent TRP channels have adhered to their promise as new pharmacological targets in the lower urinary tract (LUT) and to outline the challenges that lie ahead.• TRP vanilloid 1 (TRPV1) agonists have proven their efficacy in the treatment of neurogenic detrusor overactivity (DO), albeit at the expense of prolonged adverse effects as pelvic 'burning' pain, sensory urgency and haematuria.• TRPV1 antagonists have been very successful in preclinical studies to treat pain and DO. However, clinical trials with the first generation TRPV1 antagonists were terminated early due to hyperthermia, a serious, on-target, side-effect.• TRP vanilloid 4 (TRPV4), TRP ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) have important sensory functions in the LUT. Antagonists of these channels have shown their potential in pre-clinical studies of LUT dysfunction and are awaiting clinical validation.

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Section: Trpv1supporting

confidence: 76%

“…Compounds modulating other TRP channels in the LUT (TRPV4, TRPM8 and TRPA1) are currently being tested in pre‐clinical studies and Phase I clinical trials (Fig. ) , so hopefully these TRP channel modulators can realise the expectations of becoming t ruly r evolutionary p harmacotherapies.…”

Section: Discussionmentioning

confidence: 99%

Transient receptor potential channel modulators as pharmacological treatments for lower urinary tract symptoms (LUTS): myth or reality?

et al. 2015

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“…Clinically, the first results of intravesical capsaicin treatment in NDO patients were quite spectacular, resulting in increased bladder capacity, reduced urinary frequency and less urge incontinence (Maggi et al ., ; Fowler et al ., ; Barbanti et al ., ; Geirsson et al ., ; Chandiramani et al ., ; Cruz et al ., ; De Ridder et al ., ; de Sèze et al ., ; Wiart et al ., ). In fact, 84% experienced significant improvement of their complaints (de Sèze et al ., ).…”

Section: Lutd With Bladder Overactivitymentioning

confidence: 97%

TRP channels in lower urinary tract dysfunction

Franken

Uvin

Ridder

et al. 2014

British J Pharmacology

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Lower urinary tract dysfunction (LUTd) represents a major healthcare problem. Although it is mostly not lethal, associated social disturbance, medical costs, loss of productivity and especially diminished quality of life should not be underestimated. Although more than 15% of people suffer from a form of LUTd to some extent, pathophysiology often remains obscure. In the past 20 years, transient receptor potential (TRP) channels have become increasingly important in this field of research. These intriguing ion channels are believed to be the main molecular sensors that generate bladder sensation. Therefore, they are intensely pursued as new drug targets for both curative and symptomatic treatment of different forms of LUTd. TRPV1 was the first of its class to be investigated. Actually, even before this channel was cloned, it had already been targeted in the bladder, with clinical trials of intravesical capsaicin instillations. Several other polymodally gated TRP channels, particularly TRPM8, TRPA1 and TRPV4, also appear to play a prominent role in bladder (patho)physiology. With this review, we provide a brief overview of current knowledge on the role of these TRP channels in LUTd and their potential as molecular targets for treatment. LINKED ARTICLESThis article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx

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“…Ten trials were identified, 8 with mixed SCI and MS populations (15,(17)(18)(19)(21)(22)(23)(24) and 2 investigating UI treatments with exclusively SCI subjects (15,19) (Table 1). Treatments evaluated included BTX (2 trials) (15,16), capsaicin (6 trials) (17,18,(20)(21)(22)(23), and RTX (3 trials) (16,19,24). Seven studies were placebo controlled (15,17,19,(21)(22)(23)(24) and double blinded (15,(17)(18)(19)(22)(23)(24).…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Treatments evaluated included BTX (2 trials) (15,16), capsaicin (6 trials) (17,18,(20)(21)(22)(23), and RTX (3 trials) (16,19,24). Seven studies were placebo controlled (15,17,19,(21)(22)(23)(24) and double blinded (15,(17)(18)(19)(22)(23)(24). One trial was a crossover study (22).…”

Section: Description Of Studiesmentioning

confidence: 99%

Neurotoxin Treatments for Urinary Incontinence in Subjects With Spinal Cord Injury or Multiple Sclerosis: A Systematic Review of Effectiveness and Adverse Effects

MacDonald¹,

Monga²,

Fink³

et al. 2008

The Journal of Spinal Cord Medicine

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Background/Objective: The objective was to evaluate the effectiveness of neurotoxin treatments of urinary incontinence (UI) in individuals with spinal cord injury (SCI) or multiple sclerosis (MS). Methods: Studies were included if published in English, presented randomized adults with SCI or MS, and reported UI outcomes. Results: Ten trials randomizing 288 subjects with SCI (43%), MS (52%), or other spinal conditions (5%) and UI refractory to oral antimuscarinics were included. The overall mean age was 41 years, and 46% were women. Study durations ranged from 1 to 18 months. Treatments included botulinum toxin-A (BTX-A, 2 trials) and 2 vanilloid compounds, capsaicin (6 trials) and resiniferatoxin (4 trials). BTX-A was superior to placebo and resiniferatoxin in reducing daily UI episodes, mainly in individuals with SCI, although significant reductions vs placebo were not evident throughout the study duration. There were 1.1 fewer daily UI episodes in the BTX-A 200 unit group vs 0.1 fewer for the placebo group at the final week 24 assessment. Capsaicin was generally superior to placebo. The weighted difference between capsaicin and placebo in a pooled analysis of 2 trials enrolling subjects with either paraplegia or tetraplegia (n¼ 32) wasÀ3.8 daily UI episodes [95% CIÀ4.7 to À2.9] after 30 days. Capsaicin was comparable to resiniferatoxin. Pelvic pain and facial flushing were associated with capsaicin. Conclusion: Neurotoxins may improve refractive UI in adults with SCI or MS, although trial results were inconsistent. Trials were small in size and relatively short in duration. Further studies are needed to determine the efficacy and tolerability of long-term application.

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The Effects of Capsaicin on the Neurogenic Hyperreflexic Detrusor. A Double Blind Placebo Controlled Study in Patients With Spinal Cord Disease. Preliminary Results

Cited by 9 publications

References 0 publications

Transient receptor potential channel modulators as pharmacological treatments for lower urinary tract symptoms (LUTS): myth or reality?

Transient receptor potential channel modulators as pharmacological treatments for lower urinary tract symptoms (LUTS): myth or reality?

TRP channels in lower urinary tract dysfunction

Neurotoxin Treatments for Urinary Incontinence in Subjects With Spinal Cord Injury or Multiple Sclerosis: A Systematic Review of Effectiveness and Adverse Effects

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