Feasibility of Topical Applications of Natural High-Concentration Capsaicinoid Solutions in Patients with Peripheral Neuropathic Pain

A Retrospective Analysis

Fanny Bauchy, Andre Mouraux, Ronald Deumens, Marjolein Leerink, Antonio Ulpiano Trillig, Bernard le Polain de Waroux, Arnaud Steyaert, Quetin-Leclercq Joëlle, Patrice Forget

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. Capsaicin, one of several capsaicinoid compounds, is a potent TRPV1 agonist. Topical application at high concentration (high concentration, >1%) induces a reversible disappearance of epidermal free nerve endings and is used to treat peripheral neuropathic pain (PNP). While the benefit of low-concentration capsaicin remains controversial, the 8%-capsaicin patch (Qutenza®, 2010, Astellas, Netherlands) has shown its effectiveness. This patch is, however, costly and natural high-concentration capsaicinoid solutions may represent a cheaper alternative to pure capsaicin. Methods. In this retrospective study, 149 patients were screened, 132 were included with a diagnosis of neuropathic pain, and eighty-four were retained in the final analyses (median age: 57.5 years [IQR25-75: 44.7-67.1], male/female: 30/54) with PNP who were treated with topical applications of natural high-concentration capsaicinoid solutions (total number of applications: 137). Indications were postsurgical PNP (85.7%) and nonsurgical PNP (14.3%) (posttraumatic, HIV-related, postherpetic, and radicular PNP). Objectives. To assess the feasibility of topical applications of natural high-concentration capsaicinoid solutions for the treatment of PNP. Results. The median treated area was 250 cm2 [IQR25-75: 144-531]. The median amount of capsaicinoids was 55.1 mg [IQR25-75: 28.7-76.5] per plaster and the median concentration was 172.3 μg/cm2 [IQR25-75: 127.6-255.2]. Most patients had local adverse effects on the day of treatment, such as mild to moderate burning pain and erythema. 13.6-19.4% of the patients experienced severe pain or erythema. Following treatment, 62.5% of patients reported a lower pain intensity or a smaller pain surface, and 35% reported a sustained pain relief lasting for at least 4 weeks. Conclusion. Analgesic topical treatment with natural high-concentration capsaicinoid is feasible and may represent a low cost alternative to alleviate PNP in clinical practice.
Original languageEnglish
Article number9703036
JournalPain Research and Management
Volume2016
DOIs
Publication statusPublished - 26 Dec 2016

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Neuralgia
Capsaicin
Pain
Erythema
Nerve Endings
Therapeutics
Netherlands
Analgesics
Retrospective Studies
HIV
Costs and Cost Analysis

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Feasibility of Topical Applications of Natural High-Concentration Capsaicinoid Solutions in Patients with Peripheral Neuropathic Pain : A Retrospective Analysis. / Bauchy, Fanny; Mouraux, Andre; Deumens, Ronald; Leerink, Marjolein; Trillig, Antonio Ulpiano; Waroux, Bernard le Polain de; Steyaert, Arnaud; Joëlle, Quetin-Leclercq; Forget, Patrice.

In: Pain Research and Management, Vol. 2016, 9703036, 26.12.2016.

Research output: Contribution to journalArticle

Bauchy, Fanny ; Mouraux, Andre ; Deumens, Ronald ; Leerink, Marjolein ; Trillig, Antonio Ulpiano ; Waroux, Bernard le Polain de ; Steyaert, Arnaud ; Joëlle, Quetin-Leclercq ; Forget, Patrice. / Feasibility of Topical Applications of Natural High-Concentration Capsaicinoid Solutions in Patients with Peripheral Neuropathic Pain : A Retrospective Analysis. In: Pain Research and Management. 2016 ; Vol. 2016.
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abstract = "Background. Capsaicin, one of several capsaicinoid compounds, is a potent TRPV1 agonist. Topical application at high concentration (high concentration, >1{\%}) induces a reversible disappearance of epidermal free nerve endings and is used to treat peripheral neuropathic pain (PNP). While the benefit of low-concentration capsaicin remains controversial, the 8{\%}-capsaicin patch (Qutenza{\circledR}, 2010, Astellas, Netherlands) has shown its effectiveness. This patch is, however, costly and natural high-concentration capsaicinoid solutions may represent a cheaper alternative to pure capsaicin. Methods. In this retrospective study, 149 patients were screened, 132 were included with a diagnosis of neuropathic pain, and eighty-four were retained in the final analyses (median age: 57.5 years [IQR25-75: 44.7-67.1], male/female: 30/54) with PNP who were treated with topical applications of natural high-concentration capsaicinoid solutions (total number of applications: 137). Indications were postsurgical PNP (85.7{\%}) and nonsurgical PNP (14.3{\%}) (posttraumatic, HIV-related, postherpetic, and radicular PNP). Objectives. To assess the feasibility of topical applications of natural high-concentration capsaicinoid solutions for the treatment of PNP. Results. The median treated area was 250 cm2 [IQR25-75: 144-531]. The median amount of capsaicinoids was 55.1 mg [IQR25-75: 28.7-76.5] per plaster and the median concentration was 172.3 μg/cm2 [IQR25-75: 127.6-255.2]. Most patients had local adverse effects on the day of treatment, such as mild to moderate burning pain and erythema. 13.6-19.4{\%} of the patients experienced severe pain or erythema. Following treatment, 62.5{\%} of patients reported a lower pain intensity or a smaller pain surface, and 35{\%} reported a sustained pain relief lasting for at least 4 weeks. Conclusion. Analgesic topical treatment with natural high-concentration capsaicinoid is feasible and may represent a low cost alternative to alleviate PNP in clinical practice.",
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T2 - A Retrospective Analysis

AU - Bauchy, Fanny

AU - Mouraux, Andre

AU - Deumens, Ronald

AU - Leerink, Marjolein

AU - Trillig, Antonio Ulpiano

AU - Waroux, Bernard le Polain de

AU - Steyaert, Arnaud

AU - Joëlle, Quetin-Leclercq

AU - Forget, Patrice

PY - 2016/12/26

Y1 - 2016/12/26

N2 - Background. Capsaicin, one of several capsaicinoid compounds, is a potent TRPV1 agonist. Topical application at high concentration (high concentration, >1%) induces a reversible disappearance of epidermal free nerve endings and is used to treat peripheral neuropathic pain (PNP). While the benefit of low-concentration capsaicin remains controversial, the 8%-capsaicin patch (Qutenza®, 2010, Astellas, Netherlands) has shown its effectiveness. This patch is, however, costly and natural high-concentration capsaicinoid solutions may represent a cheaper alternative to pure capsaicin. Methods. In this retrospective study, 149 patients were screened, 132 were included with a diagnosis of neuropathic pain, and eighty-four were retained in the final analyses (median age: 57.5 years [IQR25-75: 44.7-67.1], male/female: 30/54) with PNP who were treated with topical applications of natural high-concentration capsaicinoid solutions (total number of applications: 137). Indications were postsurgical PNP (85.7%) and nonsurgical PNP (14.3%) (posttraumatic, HIV-related, postherpetic, and radicular PNP). Objectives. To assess the feasibility of topical applications of natural high-concentration capsaicinoid solutions for the treatment of PNP. Results. The median treated area was 250 cm2 [IQR25-75: 144-531]. The median amount of capsaicinoids was 55.1 mg [IQR25-75: 28.7-76.5] per plaster and the median concentration was 172.3 μg/cm2 [IQR25-75: 127.6-255.2]. Most patients had local adverse effects on the day of treatment, such as mild to moderate burning pain and erythema. 13.6-19.4% of the patients experienced severe pain or erythema. Following treatment, 62.5% of patients reported a lower pain intensity or a smaller pain surface, and 35% reported a sustained pain relief lasting for at least 4 weeks. Conclusion. Analgesic topical treatment with natural high-concentration capsaicinoid is feasible and may represent a low cost alternative to alleviate PNP in clinical practice.

AB - Background. Capsaicin, one of several capsaicinoid compounds, is a potent TRPV1 agonist. Topical application at high concentration (high concentration, >1%) induces a reversible disappearance of epidermal free nerve endings and is used to treat peripheral neuropathic pain (PNP). While the benefit of low-concentration capsaicin remains controversial, the 8%-capsaicin patch (Qutenza®, 2010, Astellas, Netherlands) has shown its effectiveness. This patch is, however, costly and natural high-concentration capsaicinoid solutions may represent a cheaper alternative to pure capsaicin. Methods. In this retrospective study, 149 patients were screened, 132 were included with a diagnosis of neuropathic pain, and eighty-four were retained in the final analyses (median age: 57.5 years [IQR25-75: 44.7-67.1], male/female: 30/54) with PNP who were treated with topical applications of natural high-concentration capsaicinoid solutions (total number of applications: 137). Indications were postsurgical PNP (85.7%) and nonsurgical PNP (14.3%) (posttraumatic, HIV-related, postherpetic, and radicular PNP). Objectives. To assess the feasibility of topical applications of natural high-concentration capsaicinoid solutions for the treatment of PNP. Results. The median treated area was 250 cm2 [IQR25-75: 144-531]. The median amount of capsaicinoids was 55.1 mg [IQR25-75: 28.7-76.5] per plaster and the median concentration was 172.3 μg/cm2 [IQR25-75: 127.6-255.2]. Most patients had local adverse effects on the day of treatment, such as mild to moderate burning pain and erythema. 13.6-19.4% of the patients experienced severe pain or erythema. Following treatment, 62.5% of patients reported a lower pain intensity or a smaller pain surface, and 35% reported a sustained pain relief lasting for at least 4 weeks. Conclusion. Analgesic topical treatment with natural high-concentration capsaicinoid is feasible and may represent a low cost alternative to alleviate PNP in clinical practice.

U2 - 10.1155/2016/9703036

DO - 10.1155/2016/9703036

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JO - Pain Research and Management

JF - Pain Research and Management

SN - 1203-6765

M1 - 9703036

ER -