Dataset Information

Systematic review of topical capsaicin for the treatment of chronic pain.

ABSTRACT:

Objective

To determine the efficacy and safety of topically applied capsaicin for chronic pain from neuropathic or musculoskeletal disorders.

Data sources

Cochrane Library, Medline, Embase, PubMed, an in-house database, and contact with manufacturers of topical capsaicin.

Study selection

Randomised controlled trials comparing topically applied capsaicin with placebo or another treatment in adults with chronic pain.

Data extraction

Primary outcome was dichotomous information for the number of patients with about a 50% reduction in pain. Outcomes were extracted at four weeks for musculoskeletal conditions and eight weeks for neuropathic conditions. Secondary outcomes were adverse events and withdrawals due to adverse events.

Data synthesis

Six double blind placebo controlled trials (656 patients) were pooled for analysis of neuropathic conditions. The relative benefit from topical capsaicin 0.075% compared with placebo was 1.4 (95% confidence interval 1.2 to 1.7) and the number needed to treat was 5.7 (4.0 to 10.0). Three double blind placebo controlled trials (368 patients) were pooled for analysis of musculoskeletal conditions. The relative benefit from topical capsaicin 0.025% or plaster compared with placebo was 1.5 (1.1 to 2.0) and the number needed to treat was 8.1 (4.6 to 34). Around one third of patients experienced local adverse events with capsaicin, which would not have been the case with placebo.

Conclusions

Although topically applied capsaicin has moderate to poor efficacy in the treatment of chronic musculoskeletal or neuropathic pain, it may be useful as an adjunct or sole therapy for a small number of patients who are unresponsive to, or intolerant of, other treatments.

SUBMITTER: Mason L

PROVIDER: S-EPMC404499 | biostudies-literature | 2004 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Systematic review of topical capsaicin for the treatment of chronic pain.

Mason Lorna L Moore R Andrew RA Derry Sheena S Edwards Jayne E JE McQuay Henry J HJ

BMJ (Clinical research ed.) 20040319 7446

<h4>Objective</h4>To determine the efficacy and safety of topically applied capsaicin for chronic pain from neuropathic or musculoskeletal disorders.<h4>Data sources</h4>Cochrane Library, Medline, Embase, PubMed, an in-house database, and contact with manufacturers of topical capsaicin.<h4>Study selection</h4>Randomised controlled trials comparing topically applied capsaicin with placebo or another treatment in adults with chronic pain.<h4>Data extraction</h4>Primary outcome was dichotomous info ...[more]

PMID: 15033881

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Project description:BACKGROUND:The objective of this study was to assess the safety, tolerability, and preliminary efficacy of NGX-4010, a capsaicin 8% patch, following pretreatment with three different topical anesthetics in patients with peripheral neuropathic pain. METHODS:This open-label, multicenter study enrolled 117 patients with post-herpetic neuralgia, HIV-associated distal sensory polyneuropathy, or painful diabetic neuropathy. Patients received pretreatment with one of three lidocaine 4%-based topical anesthetics (L.M.X.4(®) [Ferndale Laboratories Inc, Ferndale, MI], Topicaine(®) Gel [Estela Basso, Jupiter, FL], or Betacaine Enhanced Gel 4 [Tiberius Inc, Tampa, FL]) for 60 minutes followed by a single 60- or 90-minute NGX-4010 application, and were followed for 12 weeks. Tolerability and safety measures included "pain now" Numeric Pain Rating Scale (NPRS) scores, dermal assessments, medication use for treatment-related pain, adverse events (AEs), clinical laboratory parameters, physical examinations, and vital signs. The primary efficacy variable was the percentage change in mean NPRS scores for "average pain for the past 24 hours" from baseline to weeks 2 through 12. RESULTS:Treatment with NGX-4010 following pretreatment with any of the three topical anesthetics was generally safe and well tolerated. Nearly all patients completed ?90% of the planned NGX-4010 application duration. The most common treatment-related AEs, application-site burning and application-site pain, were transient, mostly mild or moderate, and could be adequately managed by local cooling or short-acting oral opioid analgesics. Although slightly more patients used medication for treatment-related discomfort following pretreatment with Topicaine compared with L.M.X.4 or Betacaine, there were no statistical differences between the topical anesthetics. Neuropathic pain reduction from baseline to weeks 2 through 12 was approximately 30% and was similar among the topical anesthetics; the proportion of responders ranged from 45% to 50%. CONCLUSION:Treatment with NGX-4010 following pretreatment with any of the three topical anesthetics was generally safe and well tolerated; no significant differences in the parameters measured were noted between the pretreatment groups.

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Dataset Information

Systematic review of topical capsaicin for the treatment of chronic pain.

Objective

Data sources

Study selection

Data extraction

Data synthesis

Conclusions

Publications

Systematic review of topical capsaicin for the treatment of chronic pain.

Similar Datasets

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