RESEARCH · December 11, 2014
TAKE-HOME MESSAGE
- The authors of this meta-analysis of six studies examined predictors of response to a capsaicin patch (Qutenza®) for post-herpetic neuralgia and HIV-associated neuropathy. Patients most likely to have a sustained (>50% decrease in mean pain intensity) or complete (pain intensity score ≤1) response were those with lower baseline pain intensity. For patients with post-herpetic neuralgia, absence of allodynia and presence of hypoesthesia and a McGill Pain Questionnaire sensory score >22 were predictors of sustained response. Women with HIV-associated neuropathy were more likely to have a sustained and complete response than men.
Neuropathic pain can be difficult to treat, and it is important to know which approaches are most effective for specific types of patients. This study describes factors that are predictive of response to a capsaicin patch.
ABSTRACT
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 mean pain intensity from baseline to Weeks 2-12, and Complete Response as an average pain intensity score ≤1 during Weeks 2-12. 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
DISCUSSION
We identified subpopulations of PHN and HIV-AN patients likely to benefit from the capsaicin patch.
The Clinical Journal of Pain
Predictors of Response in Patients With Post-Herpetic Neuralgia and HIV-Associated Neuropathy Treated With the 8% Capsaicin Patch (Qutenza®)