Capsaicin 8% Patch Safe for Peripheral Neuropathic Pain

The use of capsaicin 8% patch repeat treatment is well tolerated and may provide effective long-term benefit in patients with peripheral neuropathic pain, according to an open-label, prospective, observational study published in The Clinical Journal of Pain.1

Investigators analyzed treatment-emergent adverse events (TEAEs) and drug-related TEAEs in nondiabetic patients receiving up to 6 capsaicin 8% patch treatments over a 52-week period for post-herpetic neuralgia, HIV-associated distal sensory polyneuropathy, posttraumatic or postsurgical nerve injury, and peripheral neuropathic pain. The average daily pain score was ≥4, and retreatment occurred at 9- to 12-week intervals, depending upon clinical need.

Of 306 patients receiving treatment, TEAEs and drug-related TEAEs were observed in 252 (82.4%) and 207 (67.6%) patients, respectively. The most frequent drug-related TEAE was application site pain (n=112, 36.6%).

Sensory category shift analyses conducted from baseline to the end of the study, allowed to detect sensory deterioration/loss in up to 1 modality in 140 patients (50.4%) and deterioration/loss in 1, 2, 3, 4, or 5 modalities in 74 (26.6%), 39 (14.0%), 16 (5.8%), 7 (2.5%), and 4 (1.4%) patients, respectively. Depending on the modality, new cases of hyperesthesia or allodynia were observed in 1.1% to 3.6% of cases by the end of the study. Improvement in sensory modality by the end of the study was observed in 25.2% to 32.0% of patients. In addition, researchers found that the average daily pain level, as assessed by question 5 in the Brief Pain Inventory, was 6.6 at baseline and 4.7 at 12 months.

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According to the researchers, the use of capsaicin may also be well tolerated in other patient populations, as this therapy reduces “significant systemic absorption [and] limits the potential for drug-drug interactions or the need for dose adjustment in the elderly or patients with hepatic or renal impairment.”

Study Limitation

Considering that this phase IV study had an open-label design and patients knew which treatments they were receiving, there is potential for the placebo effect to have played a role in the findings.

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  1. Gálvez R, Navez ML, Moyle G, et al. Capsaicin 8% patch repeat treatment in nondiabetic peripheral neuropathic pain: a 52-week, open-label, single-arm, safety study. Clin J Pain. 2017;33(10):921-931.