title: Treatment of arthritis with topical capsaicin: a double-blind trial.
abstract: The neuropeptide substance P has been implicated in the pathogenesis of inflammation and pain in arthritis. In this double-blind randomized study, 70 patients with osteoarthritis (OA) and 31 with rheumatoid arthritis (RA) received capsaicin (a substance P depletor) or placebo for four weeks. The patients were instructed to apply 0.025% capsaicin cream or its vehicle (placebo) to painful knees four times daily. Pain relief was assessed using visual analog scales for pain and relief, a categorical pain scale, and physicians' global evaluations. Most of the patients continued to receive concomitant arthritis medications. Significantly more relief of pain was reported by the capsaicin-treated patients than the placebo patients throughout the study; after four weeks of capsaicin treatment, RA and OA patients demonstrated mean reductions in pain of 57% and 33%, respectively. These reductions in pain were statistically significant compared with those reported with placebo (P = 0.003 and P = 0.033, respectively). According to the global evaluations, 80% of the capsaicin-treated patients experienced a reduction in pain after two weeks of treatment. Transient burning was felt at the sites of drug application by 23 of the 52 capsaicin-treated patients; two patients withdrew from treatment because of this side effect. It is concluded that capsaicin cream is a safe and effective treatment for arthritis.
authors.affiliation: Case Western Reserve University, Cleveland, Ohio.
authors.forename: C L
authors.initials: CL
authors.lastname: Deal
authors.forename: T J
authors.initials: TJ
authors.lastname: Schnitzer
authors.forename: E
authors.initials: E
authors.lastname: Lipstein
authors.forename: J R
authors.initials: JR
authors.lastname: Seibold
authors.forename: R M
authors.initials: RM
authors.lastname: Stevens
authors.forename: M D
authors.initials: MD
authors.lastname: Levy
authors.forename: D
authors.initials: D
authors.lastname: Albert
authors.forename: F
authors.initials: F
authors.lastname: Renold
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D002211:Capsaicin / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement
chemical_list: D002211:Capsaicin