OBJECTIVES: Qutenza is a high-dose capsaicin patch used to relieve neuropathic pain from postherpetic neuralgia (PHN) and HIV-associated neuropathy (HIV-AN). In clinical studies, some patients had a dramatic response to the capsaicin patch. Our objective was to determine the baseline characteristics of patients who best benefit from capsaicin patch treatment. METHODS: We conducted a meta-analysis of 6 completed randomized and controlled Qutenza studies by pooling individual patient data. Sustained response was defined as>50% decrease in the mean pain intensity from baseline to weeks 2 to 12, and Complete Response as an average pain intensity score≤1 during weeks 2 to 12. Logistic regression was used to identify predictors of response and Complete Response, and subgroups of patients who respond best to the capsaicin patch. RESULTS:Baseline pain intensity score (BPIS)≤4 was a predictor of Sustained and Complete Response in PHN and HIV-AN patients; absence of allodynia and presence of hypoesthesia, and a McGill Pain Questionnaire (MPQ) sensory score <22 were predictors of Sustained Response in PHN patients; female sex was a predictor of Sustained and Complete Response in HIV-AN patients. Thus, characteristics associated with the highest chance of responding to the capsaicin patch were, for PHN, BPIS≤4, MPQ sensory score≤22, absence of allodynia, and presence of hypoesthesia; for HIV-AN, they were female sex and BPIS≤4. Patients with these characteristics had a statistically significantly greater chance of responding to the capsaicin patch than other patients. DISCUSSION: We identified subpopulations of PHN and HIV-AN patients likely to benefit from the capsaicin patch.
RCT Entities:
OBJECTIVES: Qutenza is a high-dose capsaicin patch used to relieve neuropathic pain from postherpetic neuralgia (PHN) and HIV-associated neuropathy (HIV-AN). In clinical studies, some patients had a dramatic response to the capsaicin patch. Our objective was to determine the baseline characteristics of patients who best benefit from capsaicin patch treatment. METHODS: We conducted a meta-analysis of 6 completed randomized and controlled Qutenza studies by pooling individual patient data. Sustained response was defined as>50% decrease in the mean pain intensity from baseline to weeks 2 to 12, and Complete Response as an average pain intensity score≤1 during weeks 2 to 12. Logistic regression was used to identify predictors of response and Complete Response, and subgroups of patients who respond best to the capsaicin patch. RESULTS: Baseline pain intensity score (BPIS)≤4 was a predictor of Sustained and Complete Response in PHN and HIV-AN patients; absence of allodynia and presence of hypoesthesia, and a McGill Pain Questionnaire (MPQ) sensory score <22 were predictors of Sustained Response in PHN patients; female sex was a predictor of Sustained and Complete Response in HIV-AN patients. Thus, characteristics associated with the highest chance of responding to the capsaicin patch were, for PHN, BPIS≤4, MPQ sensory score≤22, absence of allodynia, and presence of hypoesthesia; for HIV-AN, they were female sex and BPIS≤4. Patients with these characteristics had a statistically significantly greater chance of responding to the capsaicin patch than other patients. DISCUSSION: We identified subpopulations of PHN and HIV-AN patients likely to benefit from the capsaicin patch.
Authors: Noushin Jazebi; Chad Evans; Hima S Kadaru; Divya Kompella; Mukaila Raji; Felix Fang; Miguel Pappolla; Shao-Jun Tang; Jin Mo Chung; Bruce Hammock; Xiang Fang Journal: J Neurol Exp Neurosci Date: 2021-02-06
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Authors: Iwona Filipczak-Bryniarska; Roger M Krzyzewski; Jakub Kucharz; Anna Michalowska-Kaczmarczyk; Justyna Kleja; Jarosław Woron; Katarzyna Strzepek; Lucyna Kazior; Jerzy Wordliczek; Tomasz Grodzicki; Krzysztof Krzemieniecki Journal: Med Oncol Date: 2017-08-17 Impact factor: 3.064
Authors: Jan Vollert; Christoph Maier; Nadine Attal; David L H Bennett; Didier Bouhassira; Elena K Enax-Krumova; Nanna B Finnerup; Rainer Freynhagen; Janne Gierthmühlen; Maija Haanpää; Per Hansson; Philipp Hüllemann; Troels S Jensen; Walter Magerl; Juan D Ramirez; Andrew S C Rice; Sigrid Schuh-Hofer; Märta Segerdahl; Jordi Serra; Pallai R Shillo; Soeren Sindrup; Solomon Tesfaye; Andreas C Themistocleous; Thomas R Tölle; Rolf-Detlef Treede; Ralf Baron Journal: Pain Date: 2017-08 Impact factor: 7.926