scholarly journals 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

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Marc Giménez-Milà ◽  
Sebastián Videla ◽  
Marco-Antonio Navarro ◽  
Adela Faulí ◽  
Antonio Ojeda ◽  
...  
2017 ◽  
Vol 2 (20;2) ◽  
pp. 27-35
Author(s):  
PyungBok Lee

Background: Topical capsaicin therapy may be of benefit in providing pain relief in patients with peripheral neuropathy. Objectives: To investigate the efficacy and safety of 0.625% (50 µg/cm2 ) and 1.25% (100 µg/cm2 ) capsaicin patches (CPs) compared to conventional 0.075% capsaicin cream or placebo patches in patients suffering from peripheral neuropathy. Study Design: Early Phase II, multi-center, randomized, semi-double-blind, and placebocontrolled clinical trial. Setting: Two medical college teaching hospitals. Methods: Sixty patients were randomized to the 0.625% CP, 1.25% CP, placebo-controlled patch, or 0.075% capsaicin cream. The primary efficacy endpoint was the mean difference in the change of daily numerical rating scale (NRS) pain score. Secondary endpoints included values for the Daily Sleep Interference Scale, the percentage of patients achieving a ≥ 30% or ≥ 50% reduction in pain, and data for Global Impression Change (GIC) and EQ-5D. Results: Patients treated with the 0.625% CP and 0.075% capsaicin cream showed statistically significant improvements in pain after 6-weeks of test drug application. Daily sleep disorder scores were improved only for those patients applying the 0.075% capsaicin cream. For patient-derived GIC scores, the majority (11 of 12) of patients in the 0.625% CP group reported that their pain was improved. For the safety evaluation, 2 severe adverse events were reported for the 0.075% capsaicin cream group only. Repetitive patch application was related to minor skin problems such as a burning sensation, erythema, pruritus, and vesicles in 28 patients (46.67%). Limitations: The small sample size and relatively high dropout rates. Conclusion: Our data indicate that the 0.625% CP may prove to be an effective and safe alternative with which to treat patients with peripheral neuropathy and could replace the high concentration (8%) CP. Further studies are now needed to definitively establish efficacy. Key words: Capsaicin, patch, CP, topical capsaicin, neuropathic pain, peripheral neuropathic pain, PNP, high concentration CP


2018 ◽  
Vol 25 (11) ◽  
pp. 1689-1695
Author(s):  
Mazhar Hussain ◽  
Muhammad Arshad Qureshi ◽  
Abdul Qudoos Arain ◽  
Habib-Ur- Rehman

Background: Peripheral neuropathic pain is a devastating complication intype 2 diabetic patients with significant morbidity and mortality. Objectives: To investigate theeffect of oral vitamin D supplementation on symptoms of peripheral neuropathic pain in type 2diabetic patients. Study Design: Prospective randomized placebo controlled trial. Setting:Diabetic Clinic of Sheikh Zayed Medical College/Hospital Rahim Yar Khan. Period: Overa period of 6 months from Jan-July 2017. Methods: 116 vitamin D deficient type 2 diabeticpatients with symptoms of peripheral neuropathic pain were divided in to two groups toprescribed either oral vitamin D3 capsule 50000IU weekly or Placebo capsule for a periodof 12 weeks. Symptoms of diabetic neuropathic pain were assessed by neuropathysymptoms score (NSS) and neuropathy disability score (NDS) while Vitamin D status wasestimated by measuring the serum total 25(OH) D concentration. The primary end pointwas changes in NSS and NDS while secondary end point was changes in HbA1C and 25(OH) D concentrations from baseline. Results: After 12 weeks of vitamin D therapy, vitaminD improved its own level in interventional group (28.5±12.5 to 48.2±15.6) vs placebo group(30.6±16.2 to31.5±12.6) with p-value (0.001). This rise was accompanied by improvementin HbAIc (8.2±1.8 to 7.5±2.2) vs Placebo (7.8±1.5 to 8.0±1.8) with p-value (0.004) and NSSscore (6.02±1.5 to 4.52±0.8) vs placebo (5.82 ±1.8 to 5.65±1.5) with p-value (0.002). Howeverno significant changes were seen in NDS in both study groups. Conclusion: Oral vitamin D3therapy has positive impact on its own status as well as symptoms of peripheral neuropathicpain in type 2 diabetic patients.


2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 208-208 ◽  
Author(s):  
Sabrina Ramnarine ◽  
Barry Laird ◽  
Linda J Williams ◽  
Marie T Fallon

208 Background: Cancer-treatment related peripheral neuropathic pain is a challenging clinical problem as current interventions have limited efficacy and significant toxicities. This study aims to examine the analgesic effect of high-concentration 8% capsaicin patch in this cohort of patients. Methods: A single arm study was conducted. Patients with long-term peripheral neuropathic pain received a single application of 8% transdermal capsaicin patch to the affected area (chest wall, hands or feet). Assessments at baseline, 4 weeks and 12 weeks post-treatment included: Brief Pain Inventory (BPI) short form (pain severity and interference with function); Hospital Anxiety and Depression Scale (HADS). The primary efficacy measure was a clinically significant improvement in pain (≥ 30% reduction in total BPI score (responders) from baseline to 4 weeks and 12 weeks). Secondary efficacy measures assessed worst pain, function and associated changes in mood. Results: 19 patients, median age 61.5 all had peripheral neuropathic pain for a median of 2 years (IQR 1-3) following treatment for various types of cancer: gynecological (n = 2), breast (n = 6), colorectal (n = 8), multiple myeloma (n = 2) or other (n = 1). At 4 weeks, 37% (7/19) patients showed a clinically significant improvement in pain (≥ 30%). Of the 7 responders, 5 had > 50% reduction in pain. 16% (3/19) suggested a partial improvement (mean 17%). Of the patients reassessed at 12 weeks, 50% (7/14) were responders with all patients exhibiting a reduction in: worst pain score, -1.3 (95% CI: -2.5, -0.06; p = 0.04), interference with function, -10.9 (95% CI: -21.5, -0.4; p = 0.04) and HADS depression score, -1.7 (95% CI: -3.4, 0.02; p = 0.05). Total HADS score correlated with total BPI at 4 weeks (r = 0.68) and 12 weeks (r = 0.70). HADS depression score also correlated with BPI at 12 weeks (r = 0.73). All correlations were significant (p < 0.01). Conclusions: In patients with chronic, resistant, cancer-treatment related peripheral neuropathic pain, high-concentration 8% capsaicin patch may provide some benefit in pain severity, function and mood with the effect continuing at 12 weeks post-treatment. This may warrant further long-term follow up in a larger cohort.


2009 ◽  
Vol 31 (4) ◽  
pp. 502-510 ◽  
Author(s):  
Sunita Babbar ◽  
Jean-Francois Marier ◽  
Mohamad-Samer Mouksassi ◽  
Martin Beliveau ◽  
Geertrui F Vanhove ◽  
...  

2010 ◽  
Vol 39 (6) ◽  
pp. 1053-1064 ◽  
Author(s):  
David M. Simpson ◽  
Suzanne Gazda ◽  
Stephen Brown ◽  
Lynn R. Webster ◽  
Shiao-Ping Lu ◽  
...  

2020 ◽  
Author(s):  
Jawad Ahmad Abu-Shennar ◽  
Nurhan Bayraktar ◽  
Hatic Bebis

Abstract Aim The aim of the study was to assess the prevalence of diabetic peripheral neuropathic pain (DPNP) among adult patients suffering from type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) as well as to determine the quality of life of patients with DPNP.Materials and method The study designed in cross-sectional research model was conducted at the Jordanian Ministry of Health in Jordan, Amman during the period from 15 June 2019 to 5 October 2019. A total of 400 adult T2DM patients with DNP were recruited for the study. Data were collected by way of an assessment tool package, including descriptive data (demographics, anthropometric measurements, laboratory measurements, and clinical data), the Douleur Neuropathique4 (DN4) questionnaire, physical exam, Quality of Life Questionnaire (EQ-5D), and Numeric Pain Rating Scale (NRS). To analyze study data descriptive and inferential statistics were used.Results Results of the current study showed that the prevalence of DPNP among adult T2DM patients with DPN was high (47.8%). About half of the participants had mild or moderate pain with the most frequently reported symptoms of tingling and burning. Uncontrolled diabetes was found to be the main predictor of DPNP among patients with DPN. Participants who had DPNP reported having problems in connection with mobility, self-care, routine activities, discomfort, and anxiety or/and depression, and they had a significantly lower quality of life with poorer self-rated health status than those without DPNP. Besides, the effect of pain on their quality of life was found to be significant.Conclusion The study recommends, in accordance with the results, that strategies should be developed for an effective management of painful DPN with an integrated and interdisciplinary approach. Current clinical guideline recommendations should be followed to improve patient care and reduce the burden of the disease.


2020 ◽  
Author(s):  
Jawad Ahmad Abu-Shennar ◽  
Nurhan Bayraktar ◽  
Hatic Bebis

Abstract Aim The aim of the study was to assess the prevalence of diabetic peripheral neuropathic pain (DPNP) among adult patients suffering from type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) as well as to determine the quality of life of patients with DPNP.Materials and method The study designed in cross-sectional research model was conducted at the Jordanian Ministry of Health in Jordan, Amman during the period from 15 June 2019 to 5 October 2019. A total of 400 adult T2DM patients with DNP were recruited for the study. Data were collected by way of an assessment tool package, including descriptive data (demographics, anthropometric measurements, laboratory measurements, and clinical data), the Douleur Neuropathique4 (DN4) questionnaire, physical exam, Quality of Life Questionnaire (EQ-5D), and Numeric Pain Rating Scale (NRS). To analyze study data descriptive and inferential statistics were used.Results Results of the current study showed that the prevalence of DPNP among adult T2DM patients with DPN was high (47.8%). About half of the participants had mild or moderate pain with the most frequently reported symptoms of tingling and burning. Uncontrolled diabetes was found to be the main predictor of DPNP among patients with DPN. Participants who had DPNP reported having problems in connection with mobility, self-care, routine activities, discomfort, and anxiety or/and depression, and they had a significantly lower quality of life with poorer self-rated health status than those without DPNP. Besides, the effect of pain on their quality of life was found to be significant.Conclusion The study recommends, in accordance with the results, that strategies should be developed for an effective management of painful DPN with an integrated and interdisciplinary approach. Current clinical guideline recommendations should be followed to improve patient care and reduce the burden of the disease.


2020 ◽  
Author(s):  
Jawad Ahmad Abu-Shennar ◽  
Nurhan Bayraktar ◽  
Hatice Bebis

Abstract Aim: The aim of the study was to assess the prevalence of diabetic peripheral neuropathic pain (DPNP) among adult patients suffering from type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) as well as to determine the quality of life of patients with DPNP.Materials and method: The study designed in cross-sectional research model was conducted at the Jordanian Ministry of Health in Jordan, Amman during the period from 15 June 2019 to 5 October 2019. A total of 400 adult T2DM patients with DNP were recruited for the study. Data were collected by way of an assessment tool package, including descriptive data (demographics, anthropometric measurements, laboratory measurements, and clinical data), the Douleur Neuropathique4 (DN4) questionnaire, physical exam, Quality of Life Questionnaire (EQ-5D), and Numeric Pain Rating Scale (NRS). To analyze study data descriptive and inferential statistics were used. Results: Results of the current study showed that the prevalence of DPNP among adult T2DM patients with DPN was high (47.8%). About half of the participants had mild or moderate pain with the most frequently reported symptoms of tingling and burning. Uncontrolled diabetes was found to be the main predictor of DPNP among patients with DPN. Participants who had DPNP reported having problems in connection with mobility, self-care, routine activities, discomfort, and anxiety or/and depression, and they had a significantly lower quality of life with poorer self-rated health status than those without DPNP. Besides, the effect of pain on their quality of life was found to be significant. Conclusion: The study recommends, in accordance with the results, that strategies should be developed for an effective management of painful DPN with an integrated and interdisciplinary approach. Current clinical guideline recommendations should be followed to improve patient care and reduce the burden of the disease.


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