Capsaicin 179-mg cutaneous patch in the treatment of post-surgical neuropathic pain: a scoping review of current evidence and place in therapy

ABSTRACT

Introduction

The use of topical agents has been suggested for post-surgical neuropathic pain. A high-concentration capsaicin 179-mg cutaneous patch (Qutenza™) is licensed in adults for chronic neuropathic pain in the EU, and neuropathic pain with post-herpetic neuralgia and neuropathic pain with diabetic peripheral neuropathy in the USA. This article aims to describe the use of a topical capsaicin 179-mg cutaneous patch in the treatment of PSNP.

Area covered

This narrative review presents the relevant clinical aspects of the use of a topical capsaicin 179-mg cutaneous patch for the treatment of post-surgical neuropathic pain (PSNP). Randomized control trials, observational studies, case series, and reports investigating the clinical use of the capsaicin patch were searched through MEDLINE, EMBASE, AMED, Cochrane Library, CINAHL, Web of Science, and ROAD databases. Trials from citation lists of reviewed articles and hand-searching were added. The search concluded in September 2020. 10/20 articles were considered.

Expert opinion

Some clinical studies demonstrated the efficacy of the capsaicin 179-mg patch in PSNP as monotherapy and concomitant treatment with oral treatments. This topical treatment of PSNP is better tolerated and accepted compared with systemic treatments. To maximize the effectiveness of the treatment, correct administration recommendations should be followed.

KEYWORDS:

• post-surgical neuropathic pain
• capsaicin patch
• topical therapy
• tolerability
• administration

Acknowledgments

Editorial assistance was provided by Laura Brogelli, MD, PhD, Oriana Petrazzuolo, PhD, Chiara Degirolamo, PhD, and Aashni Shah, BSc (Polistudium SRL, Milan, Italy). This assistance was supported by Grunenthal Italia Srl.

Article highlights

• Although treatment of PSNP is mainly oral, topical agents seem to be a suitable option because of the good tolerability.

• Capsaicin, a highly selective agonist of TRPV1, is available as a 179-mg cutaneous patch for the treatment of neuropathic pain.

• Early treatment of post-surgical pain is desirable as the presence of signs and symptoms of neuropathic pain in the immediate post-surgery period may significantly increase the risk of developing PSNP.

• Pain relief with capsaicin 179 mg patch lasts up to 3 months, and satisfactory or even greater improvements may be expected after subsequent re-application.

Declaration of interest

The author was solely responsible for the development of the content of the manuscript. Grünenthal GmbH reviewed the final draft for the scientific accuracy of the data presented. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper is funded by Grunenthal Italia Srl.