Efficacité et tolérance des capsaïcinoïdes topiques dans le traitement de la douleur neuropathique. Une revue systématique et méta-analyse des essais cliniques randomisés

Abstract

Introduction: Neuropathic pain is frequent and its management can be difficult in case of unsuccessful treatment and side effects. An alternative to systemic treatments is the topical use of capsaicinoids. The goal of this work is to evaluate the efficacy of the topical use of capsaicinoids to treat neuropathic pain. Method: In agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic research of clinical trials published between 1/1/1990 and 31/08/2014, in English and French, was performed in PubMed/Central and the Cochrane Database. The indications, modalities of treatment and therapeutic results were registered. Qualitative and quantitative (meta-) analyses of the data were performed. Results: Seventeen studies were included, from 153 identified works. The extracted data permitted us to conclude that capsaicin is efficient in treating post-herpetic neuropathic pain as distal HIV-associated polyneuropathy. The data are insufficient to conclude whether the indications may be broadened. Conclusion: Topical capsaicin is effective in treating postherpetic and HIV-associated neuropathic pain. Further studies are needed to evaluate other indications and the potential place of other capsaicinoids.