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A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia.
Clin Ther. 1993 May-Jun; 15(3):510-26.CT

Abstract

A large double-blind, vehicle-controlled study of 143 patients with chronic postherpetic neuralgia (PHN) was performed to evaluate the degree of efficacy of topically applied capsaicin 0.075% cream. In addition, the safety and efficacy of long-term application of topical capsaicin in PHN was assessed by following patients in an open-label study for up to 2 years. In the double-blind phase, 143 patients with PHN of 6 months' duration or longer were enrolled. Since epidemiologic studies of patients who receive no treatment have shown that only 10% to 25% of those with PHN after 1 month will still have pain at 1 year, two separate efficacy analyses were performed: one with all evaluable patients (n = 131) and the other with 93 patients whose PHN lasted for longer than 12 months prior to study startup. All efficacy variables, including the physician's global evaluation of reduction in PHN pain, changes in pain severity on the categoric scale, visual analogue scale for pain severity, visual analogue scale for pain relief, and functional capacity scale, showed significant improvement at nearly all time points throughout the study for both patient groups, based on duration of PHN pain. In contrast, the group receiving vehicle cream remained essentially unchanged. Data from the long-term, open-label phase (up to 2 years, n = 77), which immediately followed the 6-week blinded phase, showed that the clinical benefit in patients treated for a short (6-week) period with topical capsaicin could be maintained or amplified in most patients (86%) during prolonged therapy. There were no serious adverse effects observed or reported throughout the trial; in fact, the only side effect associated with capsaicin treatment was the burning or stinging at local sites of application (in 9% of patients) during exposures of up to 2 years (long-term phase). On the basis of these data, we conclude that capsaicin 0.075% cream is a safe and effective treatment for the pain of postherpetic neuralgia and should be considered for initial management of patients with this condition.

Authors+Show Affiliations

Department of Neurology, University of Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8364943

Citation

Watson, C P., et al. "A Randomized Vehicle-controlled Trial of Topical Capsaicin in the Treatment of Postherpetic Neuralgia." Clinical Therapeutics, vol. 15, no. 3, 1993, pp. 510-26.
Watson CP, Tyler KL, Bickers DR, et al. A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. Clin Ther. 1993;15(3):510-26.
Watson, C. P., Tyler, K. L., Bickers, D. R., Millikan, L. E., Smith, S., & Coleman, E. (1993). A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. Clinical Therapeutics, 15(3), 510-26.
Watson CP, et al. A Randomized Vehicle-controlled Trial of Topical Capsaicin in the Treatment of Postherpetic Neuralgia. Clin Ther. 1993 May-Jun;15(3):510-26. PubMed PMID: 8364943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. AU - Watson,C P, AU - Tyler,K L, AU - Bickers,D R, AU - Millikan,L E, AU - Smith,S, AU - Coleman,E, PY - 1993/5/1/pubmed PY - 1993/5/1/medline PY - 1993/5/1/entrez SP - 510 EP - 26 JF - Clinical therapeutics JO - Clin Ther VL - 15 IS - 3 N2 - A large double-blind, vehicle-controlled study of 143 patients with chronic postherpetic neuralgia (PHN) was performed to evaluate the degree of efficacy of topically applied capsaicin 0.075% cream. In addition, the safety and efficacy of long-term application of topical capsaicin in PHN was assessed by following patients in an open-label study for up to 2 years. In the double-blind phase, 143 patients with PHN of 6 months' duration or longer were enrolled. Since epidemiologic studies of patients who receive no treatment have shown that only 10% to 25% of those with PHN after 1 month will still have pain at 1 year, two separate efficacy analyses were performed: one with all evaluable patients (n = 131) and the other with 93 patients whose PHN lasted for longer than 12 months prior to study startup. All efficacy variables, including the physician's global evaluation of reduction in PHN pain, changes in pain severity on the categoric scale, visual analogue scale for pain severity, visual analogue scale for pain relief, and functional capacity scale, showed significant improvement at nearly all time points throughout the study for both patient groups, based on duration of PHN pain. In contrast, the group receiving vehicle cream remained essentially unchanged. Data from the long-term, open-label phase (up to 2 years, n = 77), which immediately followed the 6-week blinded phase, showed that the clinical benefit in patients treated for a short (6-week) period with topical capsaicin could be maintained or amplified in most patients (86%) during prolonged therapy. There were no serious adverse effects observed or reported throughout the trial; in fact, the only side effect associated with capsaicin treatment was the burning or stinging at local sites of application (in 9% of patients) during exposures of up to 2 years (long-term phase). On the basis of these data, we conclude that capsaicin 0.075% cream is a safe and effective treatment for the pain of postherpetic neuralgia and should be considered for initial management of patients with this condition. SN - 0149-2918 UR - https://www.unboundmedicine.com/medline/citation/8364943/A_randomized_vehicle_controlled_trial_of_topical_capsaicin_in_the_treatment_of_postherpetic_neuralgia_ L2 - https://www.lens.org/lens/search/patent/list?q=citation_id:8364943 DB - PRIME DP - Unbound Medicine ER -