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Curr Med Res Opin. 2017 Aug;33(8):1401-1411. doi: 10.1080/03007995.2017.1322569. Epub 2017 May 4.

Treatment of painful radiculopathies with capsaicin 8% cutaneous patch.

Author information

1
a Division of Neurological Pain Research and Therapy, Department of Neurology , Universitätsklinikum Schleswig-Holstein , Campus Kiel , Germany.
2
b Chair of Neurophysiology, Medical Faculty Mannheim , Heidelberg University , Germany.
3
c Department of Neurology , University of Mainz , Germany.
4
d Department of Anesthesiology and Pain therapy , St. Josef Hospital , Wuppertal , Germany.
5
e Department of Anaesthesiology , Benedictus Hospital Tutzing and Technische Universität München , Germany.
6
f Medical Department , Astellas Pharma GmbH , Germany.
7
g Institute of Pain Medicine/Pain Practice , Wiesbaden , Germany.
8
h Department of Pain Medicine , BG University Hospital Bergmannsheil GmbH, Ruhr-University Bochum , Germany.
9
i Department of Palliative Medicine , Medical Faculty RWTH Aachen University , Germany.
10
j Department of Neurology , BG-Klinikum Duisburg , Germany.
11
k Department of Neurology , University of Würzburg , Germany.
12
l Competence Center Chronic Pruritus, Department of Dermatology , University Hospital of Münster , Germany.
13
m Department of Neurology , General Hospital Fürth , Fürth , Germany.

Abstract

BACKGROUND AND OBJECTIVE:

The treatment of neuropathic pain due to low-back (lumbosacral) radiculopathies, a common source of neuropathic pain, is challenging and often requires a multimodal therapeutic approach. The capsaicin 8% patch is the first topical analgesic licensed for peripheral neuropathic pain. To evaluate this treatment, a subset of patients with painful radiculopathy (lumbar and cervical, including ventral and dorsal rami) enrolled into the multicenter, non-interventional QUEPP study (Qutenza 2 - safety and effectiveness in peripheral neuropathic pain) was analyzed.

METHODS:

Of the 1044 study participants, 50 were diagnosed with painful radiculopathy as only peripheral neuropathic pain syndrome and were eligible for evaluation. Patients received a single treatment (visit 1) with follow-up visits 2-5 at weeks 1-2, 4, 8 and 12. Parameters assessed at all visits included pain intensity, neuropathy symptoms and side effects. Quality of life (SF-12) and painDETECT 1 questionnaires were completed at baseline and final visit. Data was analyzed by patch application site and duration of pain.

RESULTS:

Topical treatment led to a significant decrease of pain intensity between weeks 1/2 and week 12 versus baseline at the application sites representing dermatomes of ventral (N = 26) and dorsal rami (N = 13) of spinal nerves. A significant decline (p ≤ .001) of numeric pain rating scale scores was observed between weeks 1/2 following patch application and the end of observation (week 12) in the overall radiculopathy group (N = 50), and the groups with either 3 months to 2 years (N = 14) or >2 years (N = 23) duration of pain. Pain relief of at least 30% was observed in 50.0%, 71.4% and 39.1% of patients in the respective groups. Four patients experienced in total seven adverse drug reactions (application site pain or pruritus).

CONCLUSION:

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.

KEYWORDS:

Painful radiculopathy; QUEPP study; capsaicin 8% cutaneous patch; low back pain; pain duration; peripheral neuropathic pain; topical treatment

PMID:
28436279
DOI:
10.1080/03007995.2017.1322569
[Indexed for MEDLINE]

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