title: Treatment of peripheral neuropathic pain by topical capsaicin: Impact of pre-existing pain in the QUEPP-study.
abstract: BACKGROUND
  This study evaluates the impact of the duration of pre-existing peripheral neuropathic pain on the therapeutic response to the capsaicin 8% cutaneous patch.
  
  
  METHODS
  The non-interventional QUEPP (QUTENZA - safety and effectiveness in peripheral neuropathic pain) study evaluated the effectiveness of Qutenza(TM) in 1044 non-diabetic patients with peripheral neuropathic pain, who received a single application. Follow-up visits were scheduled at weeks 1-2, 4, 8 and 12. A pre-defined co-analysis of changes in average pain intensity was performed based on the duration of pre-existing pain.
  
  
  RESULTS
  In patients with pre-existing pain for <6 months, the mean relative change of the numeric pain rating scale score on days 7-14 to week 12 versus baseline was -36.6% [4.6 standard error of the mean (SEM); n = 105], -25.1% (1.9 SEM; n = 311) in patients with pain duration of 6 months to 2 years, -22.3% (1.6 SEM; n = 391) in patients with pain for >2-10 years, and -19.2% (2.6 SEM; n = 99) in patients with pain for >10 years. Thirty percent and 50% responder rates were 61.7% and 39.3% in patients with pre-existing pain for <6 months, 42.3% and 23.3% in patients with pain for 6 months to 2 years, 40.9% and 21.6% in patients with pain for >2-10 years, and 32.3% and 14.1% in patients with pain for >10 years.
  
  
  CONCLUSIONS
  The highest treatment response to the capsaicin 8% cutaneous patch was observed in patients with a history of pre-existing peripheral neuropathic pain of less than 6 months, suggesting that early initiation of topical treatment might be indicated.
authors.affiliation: Fürth Hospital, Department of Neurology, University of Erlangen-Nuremberg, Germany.
authors.forename: C G
authors.initials: CG
authors.lastname: Maihöfner
authors.forename: M-L S
authors.initials: ML
authors.lastname: Heskamp
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002211:Capsaicin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000523:psychology; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D002211:Capsaicin