Long-Term Capsaicin Patch Use Improves Pain, QOL in Peripheral Neuropathic Pain

Repeated applications of a high-concentration (179 mg) capsaicin patch (HCCP) may lead to progressive and sustained improvements in pain, sleep quality, mood, and overall quality of life in patients with peripheral neuropathic pain following surgical or traumatic nerve injury (PNI), according to study results published in Pain and Therapy.

Peripheral neuropathic pain following surgical or traumatic nerve injury is a debilitating condition that significantly impacts patients’ daily functioning and is often resistant to systemic pharmacologic treatments, which can carry burdensome adverse effects and limited efficacy. While HCCP is approved for peripheral neuropathic pain and offers localized, nonsystemic relief, evidence on its long-term, repeated use in PNI has been limited.

Researchers conducted a retrospective, noninterventional cohort study to evaluate the effectiveness of repeated HCCP therapy among patients with PNI. A total of 499 adults enrolled in the German Pain e-Registry were included in the analysis. All patients received at least 1 HCCP treatment and had 12 months of follow-up. They were assessed at regular intervals for pain intensity (mean pain intensity), sleep disturbance, affective symptoms, quality of life, and use of systemic analgesics. Outcomes were stratified by number of HCCP applications (1-4 treatments).

Pain relief improved incrementally with each treatment. Mean pain intensity decreased from a baseline of 52.5 mm to 21.5 mm after 4 treatments. The percentage of patients achieving 30% or greater reduction in mean pain intensity increased markedly with repeated treatment: 25.8% (1 treatment), 44.9% (2 treatments), 85.3% (3 treatments), and 97.8% (4 treatments).

Parallel gains were observed in sleep scores and mood metrics. Notably, moderate to severe anxiety decreased from 38.5% at baseline to 17.0% after 4 treatments (P <.001). Reductions in systemic medication use were also substantial: antidepressant use declined by 52.1%, antiepileptics by 43.2%, and high-potency opioids by 57.0%. Adverse events were mostly mild, localized application-site reactions that became less frequent with repeated treatment.

Limitations of the study include its retrospective, non-randomized design, absence of a control group, and potential for selection bias. As an observational study, the findings cannot confirm causality between HCCP treatment and clinical outcomes.

The researchers concluded, “[H]CCP provides an expansion of the limited therapeutic armamentarium of effective and safe treatment options for managing PNI. It may be considered as an earlier treatment option for this condition.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Clinical Pain Advisor