Capsaicin 8% dermal patch in clinical practice: an expert opinion. (23rd July 2020)

• Record Type: Journal Article
• Authors: Bonezzi, Cesare; Costantini, Amedeo; Cruccu, Giorgio; Fornasari, Diego M.M.; Guardamagna, Vittorio; Palmieri, Vincenzo; Polati, Enrico; Zini, Pierangelo; Dickenson, Anthony H
• Is Part Of: Expert opinion on pharmacotherapy. Volume 21:Number 11(2020)
• Page Start: 1377
• Page End: 1387
• Publication Date: 2020-07-23
• Subjects: Neuropathic pain -- topical treatment -- capsaicin -- TRPV1 receptors -- fibers; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2020.1759550
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction: Neuropathic pain (NP) is caused by a lesion or disease of the somatosensory system, which can severely impact patients' quality of life. The current-approved treatments for NP comprise of both centrally acting agents and topical drugs, including capsaicin 8% dermal patches, which is approved for the treatment of peripheral NP. Areas covered: The authors summarize literature data regarding capsaicin use in patients who suffer from NP and discuss the clinical applications of this topical approach. Expert opinion: Overall, the capsaicin 8% dermal patch is as effective in reducing pain intensity as other centrally active agents (i.e. pregabalin). Some studies have also reported fewer systemic side effects, a faster onset of action and superior treatment satisfaction compared with systemic agents. In our opinion, capsaicin 8% dermal patches also present additional advantages, such as a good systemic tolerability, the scarcity of adverse events, the possibility to combine it with other agents, and a good cost-effective profile. It is important to note that, as the mechanism of action of capsaicin 8% is the 'defunctionalization' of small afferent fibers through interaction with TRPV1 receptors, the peripheral expression of this receptor on nociceptor fibers, is crucial to predict patient's response to treatment.