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Abstract

Neuropathic pain is thought to affect up to 8% of the adult population in the UK. The condition can severely impact on patients' quality of life and can be difficult to treat. The capsaicin 8% patch has been developed to directly target the source of peripheral neuropathic pain and has been shown to provide pain relief for up to 3 months from a single 30- or 60-minute application. Adherence to the capsaicin 8% patch application procedure is important to achieve effective treatment. The authors are a group of health professionals experienced in using the capsaicin 8% patch. In this article the authors describe the optimal patch application procedure from their real-world clinical experience and provide recommendations on how to optimize the therapeutic benefit of the patch. Other key aspects of the application procedure are also addressed, including the importance of patient management, the ideal treatment setting, the best way to manage application-associated discomfort and post-treatment care. The observations and learning that the authors have gained from their clinical experience with the capsaicin 8% patch will help others to maximize the benefit gained with this novel treatment option.

References

  • Astellas Pharma Europe Ltd (2011) Summary of product characteristics: Qutenza 179 mg cutaneous patch. http://tinyurl.com/4y9hahb (accessed 09 May 2011) Google Scholar
  • AstraZeneca LP (2004) EMLA: CREAM (lidocaine 2.5% and prilocaine 2.5%). http://tinyurl.com/3mtvtc7 (accessed 09 May 2011) Google Scholar
  • Backonja M, Wallace MS, Blonsky ER et al. (2008) NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: A randomised, double-blind study. Lancet Neurol 7(12): 1106–12 Crossref, MedlineGoogle Scholar
  • Backonja MM, Irving G, Argoff C (2006) Rational multidrug therapy in the treatment of neuropathic pain. Curr Pain Headache Rep 10(1): 34–8 Crossref, MedlineGoogle Scholar
  • Backonja MM, Malan TP, Vanhove GF, Tobias JK (2010) NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: A randomized, double-blind, controlled study with an open-label extension. Pain Med 11(4): 600–8 Crossref, MedlineGoogle Scholar
  • Baron R, Binder A, Wasner G (2010) Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol 9(8): 807–19 Crossref, MedlineGoogle Scholar
  • Caterina MJ, Julius D (2001) The vanilloid receptor: A molecular gateway to the pain pathway. Annu Rev Neurosci 24: 487–517 Crossref, MedlineGoogle Scholar
  • Doth AH, Hansson PT, Jensen MP, Taylor RS (2010) The burden of neuropathic pain: a systematic review and meta-analysis of health utilities. Pain 149(2): 338–44 Crossref, MedlineGoogle Scholar
  • Dray A (2008) Neuropathic pain: emerging treatments. Br J Anaesth 101(1): 48–58 Crossref, MedlineGoogle Scholar
  • Gilron I, Watson CP, Cahill CM, Moulin DE (2006) Neuropathic pain: A practical guide for the clinician. CMAJ 175(3): 265–75 Crossref, MedlineGoogle Scholar
  • Kennedy WR, Vanhove GF, Lu SP et al. (2010) A randomized, controlled, open-label study of the long-term effects of NGX-4010, a high-concentration capsaicin patch, on epidermal nerve fiber density and sensory function in healthy volunteers. J Pain 11(6): 579–87 Crossref, MedlineGoogle Scholar
  • Malmberg AB, Mizisin AP, Calcutt NA, von Stein T, Robbins WR, Bley KR (2004) Reduced heat sensitivity and epidermal nerve fiber immunostaining following single applications of a high-concentration capsaicin patch. Pain 111(3): 360–7 Crossref, MedlineGoogle Scholar
  • O'Connor AB, Dworkin RH (2009) Treatment of neuropathic pain: An overview of recent guidelines. Am J Med 122(10 Suppl): S22–S32 Crossref, MedlineGoogle Scholar
  • Purves D, Augustine GJ, Fitzpatrick D et al. eds (2001) Neuroscience. Sinauer Associates, Inc, Sunderland MedlineGoogle Scholar
  • Simpson DM, Brown S, Tobias J (2008) Controlled trial of high-concentration capsaicin patch for treatment of painful HIV neuropathy. Neurology 70(24): 2305–13 Crossref, MedlineGoogle Scholar
  • Torrance N, Smith BH, Bennett MI, Lee AJ (2006) The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain 7(4): 281–9 Crossref, MedlineGoogle Scholar
  • Torrance N, Smith BH, Watson MC, Bennett MI (2007) Medication and treatment use in primary care patients with chronic pain of predominantly neuropathic origin. Fam Pract 24(5): 481–5 Crossref, MedlineGoogle Scholar
  • Treede RD, Jensen TS, Campbell JN et al. (2008) Neuropathic pain: Redefinition and a grading system for clinical and research purposes. Neurology 70(18): 1630–5 Crossref, MedlineGoogle Scholar
  • Vanhove GF, Wallace M, Irving G, Backonja M, Webster LR, Tobias JK (2010) Integrated safety analyses of NGX-4010, an 8% capsaicin patch, in patients with peripheral neuropathic pain. 13th World Congress on Pain; Montréal, Québec, Canada; August 29–September 2, (abstract PH 101) Google Scholar
  • Webster LR, Backonja M, Irving GA, Tobias JK, Vanhove GF (2010) Reduction in neuropathic pain in patients with post-herpetic neuralgia, HIV-associated neuropathy or painful diabetic neuropathy following treatment with QUTENZA™ 8% capsaicin patch. 14th Congress of the European Federation of Neurological Societies; Geneva, Switzerland; September 25–28 (abstract P1575) Google Scholar

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