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The treatment of neuropathic pain caused due to low-back (lumbosacral) radiculopathies, is challenging and it often requires a multimodal therapeutic approach.
Radiculopathy
is a condition of pain, tingling, numbness, and weakness among the nerves of
the spine, especially in the areas of lower back and neck. To counter this neuropathic
pain, Capsaicin 8% patch is one of the best treatment, and this can be utterly
observed through this study results.
The
treatment of neuropathic pain caused due to low-back (lumbosacral)
radiculopathies, is challenging and it often requires a multimodal therapeutic
approach. The 8% capsaicin patch is the first topical analgesic approved for
peripheral neuropathic pain. To evaluate its efficacy, a subset of patients
with painful radiculopathy (cervical and lumbar, including ventral and dorsal
rami) enrolled into the multicenter, non-interventional QUEPP study (Qutenza2 –
safety and effectiveness in peripheral neuropathic pain) were analysed.
Out of
the 1044 study participants, 50 were diagnosed with painful radiculopathy as
only peripheral neuropathic pain syndrome and were eligible for the evaluation.
Patients received a single treatment (visit 1) and follow-up visits 2–5 at
weeks 1–2, 4, 8 and 12. Parameters assessed at all visits included pain
intensity, neuropathy symptoms, and side effects. Quality of life (SF-12) and
pain DETECT1 questionnaires were completed at baseline and final visit. Data
were analyzed by monitoring the patch application site and duration of pain.
Topical application led to a significant decrease in the
pain intensity between weeks 1/2 and week 12 versus baseline at the application
sites representing dermatomes of ventral (N = 26) and dorsal rami (N = 13) of
spinal nerves. A significant decline (p ≤ .001) of numeric pain rating scale scores
was observed between weeks 1/2 following patch application and the end of
observation (week 12) in the overall radiculopathy group (N = 50), and the
groups with either 3 months to 2 years (N = 14) or >2 years (N = 23)
duration of pain. Pain relief of at least 30% was observed in 50.0%, 71.4% and
39.1% of patients in the respective groups. Four patients experienced in total
seven adverse drug reactions (application site pain or pruritus).
Effective neuropathic pain relief was observed after
patch application within the innervation territories of both dorsal and ventral
branches of the spinal nerve. Further controlled randomized trials are
indicated.
Current Medical Research and Opinion
Treatment of painful radiculopathies with capsaicin 8% cutaneous patch
R.Baron et al.
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