Capsaicin 8% Patch for Peripheral Neuropathic Pain: Review of Treatment Best Practice from ‘Real-World‘ Clinical Experience

Abstract

200 patients with a variety of neuropathic pain etiologies including postherpetic neuralgia, peripheral neuropathy and cancer-related neuropathy. These patients, a slight majority of whom were female, had experienced neuropathic pain for varied lengths of time (3 months to >15 years) and the majority were receiving concomitant medications for their pain at the time of capsaicin 8% patch treatment. Observations by the group suggest that patients with positive symptoms might respond best to therapy. To optimize response to treatment, the group reports that it is important to achieve good adhesion of the patch to the skin. The experience of the group is that the capsaicin 8% patch is a tolerable treatment and local anesthetic pretreatment may not always be required. Cooling measures used after treatments were found to be the most practical and beneficial means of relieving any treatment-related discomfort. The group observed that transient, clinically important increases in blood pressure owing to treatment-related discomfort are very rare and they have seen no correlation between treatment-related discomfort or erythema and response to treatment. In the real-life clinical setting, response to capsaicin 8% patch treatment may be higher than observed in the clinical trial program. Response to retreatment also appears to be equal to that of the first treatment, even in patients treated for the fifth time. It was also observed that patients receiving capsaicin 8% patch treatment are often able to reduce their intake of concomitant pain medications. Observations from real-life use of the capsaicin 8% patch will help to maximize its therapeutic potential.