Skip to main content
Top
Published in: BMC Anesthesiology 1/2014

Open Access 01-12-2014 | Research article

Assessment of the feasibility of high-concentration capsaicin patches in the pain unit of a tertiary hospital for a population of mixed refractory peripheral neuropathic pain syndromes in Non-diabetic patients

Authors: Marc Giménez-Milà, Sebastián Videla, Marco-Antonio Navarro, Adela Faulí, Antonio Ojeda, Ana Bogdanovich, Luis-Alfonso Moreno, Clara Hernández-Cera, Carme Busquets

Published in: BMC Anesthesiology | Issue 1/2014

Login to get access

Abstract

Background

High-concentration-capsaicin-patches (Qutenza®) have been put on the market as a treatment for peripheral neuropathic pain. A minimum infrastructure and a determinate skill set for its application are required. Our aim was to assess the feasibility of treatment with high-concentration-capsaicin-patches in clinical practice in a variety of refractory peripheral neuropathic pain syndromes in non-diabetic patients.

Methods

Observational, prospective, single-center study of patients attended to in the Pain Unit of a tertiary hospital, ≥18 year-old non-responders to multimodal analgesia of both genders. The feasibility for the application of capsaicin patch in clinical practice was evaluated by means of the number of patients controlled per day when this one was applied and by means of the times used for patch application.

Results

Between October 2010 and September 2011, 20 consecutive non-diabetic patients (7 males, 13 females) with different diagnoses of refractory peripheral neuropathic pain syndromes, with a median (range) age of 60 (33–88) years-old were treated with a single patch application. The median (range) number of patients monitored per day was not modified when the capsaicin patch was applied [27 (26–29)] in comparison with it was not applied [28 (26–30)]. The median (range) total time to determine and mark the painful area was 9 (6–15) minutes and of patch application was 60 (58–65) minutes. No important adverse reactions were observed.

Conclusion

High-concentration-capsaicin-patch treatment was feasible in our unit for the treatment of a population with refractory peripheral neuropathic pain. The routine of our unit was not affected by its use.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sindrup SH, Jensen TS: Efficacy of pharmacological treatments of neuropathic pain: An update and effect related to mechanism of drug action. Pain. 1999, 83 (3): 389-400. 10.1016/S0304-3959(99)00154-2.CrossRefPubMed Sindrup SH, Jensen TS: Efficacy of pharmacological treatments of neuropathic pain: An update and effect related to mechanism of drug action. Pain. 1999, 83 (3): 389-400. 10.1016/S0304-3959(99)00154-2.CrossRefPubMed
2.
go back to reference Jackson KC: Pharmacotherapy for neuropathic pain. Pain Pract. 2006, 1: 27-33.CrossRef Jackson KC: Pharmacotherapy for neuropathic pain. Pain Pract. 2006, 1: 27-33.CrossRef
3.
go back to reference Cruccu G, Aziz TZ, Garcia-Larrea L, Hansson P, Jensen TS, Lefaucheur JP, Simpson BA, Taylor RS: EFNS guidelines on neurostimulation therapy for neuropathic pain. Eur J Neurol. 2007, 14 (9): 952-970. 10.1111/j.1468-1331.2007.01916.x.CrossRefPubMed Cruccu G, Aziz TZ, Garcia-Larrea L, Hansson P, Jensen TS, Lefaucheur JP, Simpson BA, Taylor RS: EFNS guidelines on neurostimulation therapy for neuropathic pain. Eur J Neurol. 2007, 14 (9): 952-970. 10.1111/j.1468-1331.2007.01916.x.CrossRefPubMed
4.
go back to reference Dworkin RH, O'Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice AS, Stacey BR, Treede RD, Turk DC, Wallace MS: Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain. 2007, 132 (3): 237-251. 10.1016/j.pain.2007.08.033.CrossRefPubMed Dworkin RH, O'Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice AS, Stacey BR, Treede RD, Turk DC, Wallace MS: Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain. 2007, 132 (3): 237-251. 10.1016/j.pain.2007.08.033.CrossRefPubMed
5.
go back to reference Moulin DE, Clark AJ, Gilron I, Ware MA, Watson CP, Sessle BJ, Coderre T, Morley-Forster PK, Stinson J, Boulanger A, Peng P, Finley GA, Taenzer P, Squire P, Dion D, Cholkan A, Gilani A, Gordon A, Henry J, Jovey R, Lynch M, Mailis-Gagnon A, Panju A, Rollman GB, Velly A: Pharmacological management of chronic neuropathic pain - consensus statement and guidelines from the canadian pain society. Pain Res Manag. 2007, 12 (1): 13-21.CrossRefPubMedPubMedCentral Moulin DE, Clark AJ, Gilron I, Ware MA, Watson CP, Sessle BJ, Coderre T, Morley-Forster PK, Stinson J, Boulanger A, Peng P, Finley GA, Taenzer P, Squire P, Dion D, Cholkan A, Gilani A, Gordon A, Henry J, Jovey R, Lynch M, Mailis-Gagnon A, Panju A, Rollman GB, Velly A: Pharmacological management of chronic neuropathic pain - consensus statement and guidelines from the canadian pain society. Pain Res Manag. 2007, 12 (1): 13-21.CrossRefPubMedPubMedCentral
6.
go back to reference Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, Nurmikko T: EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010, 17 (9): 1113-e88-CrossRefPubMed Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, Nurmikko T: EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010, 17 (9): 1113-e88-CrossRefPubMed
7.
go back to reference Anand P, Bley K: Topical capsaicin for pain management: Therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch. Br J Anaesth. 2011, 107 (4): 490-502. 10.1093/bja/aer260.CrossRefPubMedPubMedCentral Anand P, Bley K: Topical capsaicin for pain management: Therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch. Br J Anaesth. 2011, 107 (4): 490-502. 10.1093/bja/aer260.CrossRefPubMedPubMedCentral
9.
go back to reference Armstrong EP, Malone DC, McCarberg B, Panarites CJ, Pham SV: Cost-effectiveness analysis of a new 8% capsaicin patch compared to existing therapies for postherpetic neuralgia. Curr Med Res Opin. 2011, 27 (5): 939-950. 10.1185/03007995.2011.562885.CrossRefPubMed Armstrong EP, Malone DC, McCarberg B, Panarites CJ, Pham SV: Cost-effectiveness analysis of a new 8% capsaicin patch compared to existing therapies for postherpetic neuralgia. Curr Med Res Opin. 2011, 27 (5): 939-950. 10.1185/03007995.2011.562885.CrossRefPubMed
10.
go back to reference Darba J, Kaskens L, Perez-Alvarez N: Neuropathic pain: a budget impact analysis to estimate costs due to the introduction of Qutenza® on the Spanish market. Value Health. 2011, 14: A411-CrossRef Darba J, Kaskens L, Perez-Alvarez N: Neuropathic pain: a budget impact analysis to estimate costs due to the introduction of Qutenza® on the Spanish market. Value Health. 2011, 14: A411-CrossRef
11.
go back to reference Clifford DB, Simpson DM, Brown S, Moyle G, Brew BJ, Conway B, Tobias JK, Vanhove GF: A randomized, double-blind, controlled study of NGX-4010, a capsaicin 8% dermal patch, for the treatment of painful HIV-associated distal sensory polyneuropathy. J Acquir Immune Defic Syndr. 2012, 59 (2): 126-133. 10.1097/QAI.0b013e31823e31f7.CrossRefPubMed Clifford DB, Simpson DM, Brown S, Moyle G, Brew BJ, Conway B, Tobias JK, Vanhove GF: A randomized, double-blind, controlled study of NGX-4010, a capsaicin 8% dermal patch, for the treatment of painful HIV-associated distal sensory polyneuropathy. J Acquir Immune Defic Syndr. 2012, 59 (2): 126-133. 10.1097/QAI.0b013e31823e31f7.CrossRefPubMed
12.
go back to reference Webster LR, Peppin JF, Murphy FT, Lu B, Tobias JK, Vanhove GF: Efficacy, safety, and tolerability of NGX-4010, capsaicin 8% patch, in an open-label study of patients with peripheral neuropathic pain. Diabetes Res Clin Pract. 2011, 93 (2): 187-197. 10.1016/j.diabres.2011.04.010.CrossRefPubMed Webster LR, Peppin JF, Murphy FT, Lu B, Tobias JK, Vanhove GF: Efficacy, safety, and tolerability of NGX-4010, capsaicin 8% patch, in an open-label study of patients with peripheral neuropathic pain. Diabetes Res Clin Pract. 2011, 93 (2): 187-197. 10.1016/j.diabres.2011.04.010.CrossRefPubMed
14.
go back to reference Backonja M, Wallace MS, Blonsky ER, Cutler BJ, Malan P, Rauck R, Tobias J: NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: A randomised, double-blind study. Lancet Neurol. 2008, 7 (12): 1106-1112. 10.1016/S1474-4422(08)70228-X.CrossRefPubMed Backonja M, Wallace MS, Blonsky ER, Cutler BJ, Malan P, Rauck R, Tobias J: NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: A randomised, double-blind study. Lancet Neurol. 2008, 7 (12): 1106-1112. 10.1016/S1474-4422(08)70228-X.CrossRefPubMed
15.
go back to reference Nolano M, Simone DA, Wendelschafer-Crabb G, Johnson T, Hazen E, Kennedy WR: Topical capsaicin in humans: Parallel loss of epidermal nerve fibers and pain sensation. Pain. 1999, 81 (1–2): 135-145.CrossRefPubMed Nolano M, Simone DA, Wendelschafer-Crabb G, Johnson T, Hazen E, Kennedy WR: Topical capsaicin in humans: Parallel loss of epidermal nerve fibers and pain sensation. Pain. 1999, 81 (1–2): 135-145.CrossRefPubMed
16.
go back to reference Caterina MJ, Julius D: The vanilloid receptor: A molecular gateway to the pain pathway. Annu Rev Neurosci. 2001, 24: 487-517. 10.1146/annurev.neuro.24.1.487.CrossRefPubMed Caterina MJ, Julius D: The vanilloid receptor: A molecular gateway to the pain pathway. Annu Rev Neurosci. 2001, 24: 487-517. 10.1146/annurev.neuro.24.1.487.CrossRefPubMed
Metadata
Title
Assessment of the feasibility of high-concentration capsaicin patches in the pain unit of a tertiary hospital for a population of mixed refractory peripheral neuropathic pain syndromes in Non-diabetic patients
Authors
Marc Giménez-Milà
Sebastián Videla
Marco-Antonio Navarro
Adela Faulí
Antonio Ojeda
Ana Bogdanovich
Luis-Alfonso Moreno
Clara Hernández-Cera
Carme Busquets
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2014
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/1471-2253-14-120

Other articles of this Issue 1/2014

BMC Anesthesiology 1/2014 Go to the issue