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Capsaicin 8% dermal patch in peripheral neuropathic pain: a profile of its use

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posted on 19.12.2019 by Sheridan M. Hoy

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Funding: The preparation of this review was not supported by any external funding.

Conflict of interest: S. M. Hoy is an employee of Adis International Ltd./Springer Nature, is responsible for the article content and declares no conflicts of interest.

Additional information about this Adis Drug Review can be found here.

Abstract

A dermal patch containing a high (8%) capsaicin concentration (hereafter referred to as the capsaicin 8% dermal patch) [Qutenza®] is a useful option for the treatment of peripheral neuropathic pain (PNP). It is indicated in the EU for the treatment of PNP in adults, either alone or in combination with other medicinal products for pain. Prolonged exposure to capsaicin (the main pungent component in hot chilli peppers) appears to engender analgesia/pain relief by inducing cutaneous nociceptor ‘defunctionalisation’ [i.e. a cascade of events, including a reduction in TRPV1 (transient receptor potential vanilloid-1) receptor sensitivity to various painful or noxious stimuli, resulting in impaired local nociceptor function for an extended period]. Across clinical and real-world studies in patients with painful diabetic peripheral neuropathy (PDPN) or non-diabetic PNP, including post-herpetic neuralgia (PHN) and HIV-associated neuropathy, single applications of the capsaicin 8% dermal patch generally relieved pain and improved health-related quality of life, patient status and/or treatment satisfaction. Pain relief was at least sustained following repeated applications for ≤ 52 weeks. As the capsaicin 8% dermal patch is associated with minimal systemic absorption, its use is expected to result in few systemic adverse events or drug–drug interactions.

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