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Treatment of Painful Diabetic Neuropathy With Topical Capsaicin: A Multicenter, Double-blind, Vehicle-Controlled Study

Treatment of Painful Diabetic Neuropathy With Topical Capsaicin: A Multicenter, Double-blind,... Abstract A multicenter study was conducted to establish the efficacy of topical 0.075% capsaicin cream in relieving the pain associated with diabetic neuropathy. Capsaicin or vehicle cream was applied to painful areas four times per day for 8 weeks in patients randomly assigned to one of two groups. Pain intensity and relief were recorded at 2-week intervals using physician's global evaluation and visual analog scales. Analysis at final visit for 252 patients showed statistical significance favoring capsaicin compared with vehicle for the following: 69.5% vs 53.4% pain improvement by the physician's global evaluation scale, 38.1% vs 27.4% decrease in pain intensity, and 58.4% vs 45.3% improvement in pain relief. With the exception of transient burning, sneezing, and coughing, capsaicin was well tolerated. Study results suggest that topical capsaicin cream is safe and effective in treating painful diabetic neuropathy. (Arch Intern Med. 1991;151:2225-2229) References 1. Ellenberg M. Treatment of diabetic neuropathy with diphenylhydantoin . N Y State J Med. 1968;68:2653-2655. 2. Rull JA, Quibrera R, Gonzalez-Millan H, Castaneda OL. Symptomatic treatment of peripheral diabetic neuropathy with carbamazepine (Tegretol): double blind crossover trial . Diabetologia. 1969;5:215-218.Crossref 3. Davis JL, Lewis SB, Gerich JE, Kaplan RA, Schultz TA, Wallin JD. Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine . JAMA. 1977;238:2291-2292.Crossref 4. Gomez-Perez FJ, Rull JA, Dies H, Rodriguez-Rivera JG, Gonzalez-Barranco J, Lozano-Castaneda O. Nortriptyline and fluphenazine in the symptomatic treatment of diabetic neuropathy: a double-blind cross-over study . Pain. 1985;23:395-400.Crossref 5. Dejgard A, Peterson P, Kastrup J. Mexiletine for treatment of chronic painful diabetic neuropathy . Lancet. 1988;1:9-11.Crossref 6. Kvinesdal B, Molin J, Froland A, Gram LF. Imipramine treatment of painful diabetic neuropathy . JAMA. 1984;251:1727-1730.Crossref 7. Max MB, Culnane M, Schafer SC, et al. Amitriptyline relieves diabetic neuropathy pain in patients with normal or depressed mood . Neurology. 1987;37:589-596.Crossref 8. Watson CPN, Evans RJ, Watt VR. Post-herpetic neuralgia and topical capsaicin . Pain. 1988;33:333-400.Crossref 9. Bernstein JE, Bickers DR, Dahl MV, Roshal JY. Treatment of chronic postherpetic neuralgia with topical capsaicin . J Am Acad Dermatol. 1987;17:93-96.Crossref 10. Bernstein JE, Korman NJ, Bickers DR, Dahl MV, Millikan LE. Topical capsaicin treatment of chronic postherpetic neurolgia . J Am Acad Dermatol. 1989;21:265-270.Crossref 11. Watson CPN, Evans RJ, Watt VR. The post-mastectomy pain syndrome and the effect of topical capsaicin . Pain. 1989;38:177-186.Crossref 12. Fitzgerald M. Capsaicin and sensory neurons: a review . Pain. 1983;15:109-130.Crossref 13. Lynn B. Capsaicin: actions on nociceptive C-fibres and therapeutic potential . Pain. 1990;41:61-69.Crossref 14. Kenins P. Responses of single nerve fibres to capsaicin applied to the skin . Neurosci Lett. 1982;29:83-88.Crossref 15. Gamse R, Petsche U, Lembeck F, Jancso G. Capsaicin applied to peripheral nerve inhibits axoplasmic transport of substance P and somatostatin . Brain Res. 1982;239:447-462.Crossref 16. Gowdey CW. A guide to the pharmacology of placebos . Can Med Assoc J. 1983;128:921-925. 17. Nielsen PG. Treatment of rosacea with 1% metronidazole cream: a double-blind study . Br J Dermatol. 1983;108:327-332.Crossref 18. Tandan R, Lewis G, Fries T. Safety of topical capsaicin in diabetic neuropathy . Neurology. 1990;40( (suppl) ):160. Abstract. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Treatment of Painful Diabetic Neuropathy With Topical Capsaicin: A Multicenter, Double-blind, Vehicle-Controlled Study

Archives of Internal Medicine , Volume 151 (11) – Nov 1, 1991

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400110079017
Publisher site
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Abstract

Abstract A multicenter study was conducted to establish the efficacy of topical 0.075% capsaicin cream in relieving the pain associated with diabetic neuropathy. Capsaicin or vehicle cream was applied to painful areas four times per day for 8 weeks in patients randomly assigned to one of two groups. Pain intensity and relief were recorded at 2-week intervals using physician's global evaluation and visual analog scales. Analysis at final visit for 252 patients showed statistical significance favoring capsaicin compared with vehicle for the following: 69.5% vs 53.4% pain improvement by the physician's global evaluation scale, 38.1% vs 27.4% decrease in pain intensity, and 58.4% vs 45.3% improvement in pain relief. With the exception of transient burning, sneezing, and coughing, capsaicin was well tolerated. Study results suggest that topical capsaicin cream is safe and effective in treating painful diabetic neuropathy. (Arch Intern Med. 1991;151:2225-2229) References 1. Ellenberg M. Treatment of diabetic neuropathy with diphenylhydantoin . N Y State J Med. 1968;68:2653-2655. 2. Rull JA, Quibrera R, Gonzalez-Millan H, Castaneda OL. Symptomatic treatment of peripheral diabetic neuropathy with carbamazepine (Tegretol): double blind crossover trial . Diabetologia. 1969;5:215-218.Crossref 3. Davis JL, Lewis SB, Gerich JE, Kaplan RA, Schultz TA, Wallin JD. Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine . JAMA. 1977;238:2291-2292.Crossref 4. Gomez-Perez FJ, Rull JA, Dies H, Rodriguez-Rivera JG, Gonzalez-Barranco J, Lozano-Castaneda O. Nortriptyline and fluphenazine in the symptomatic treatment of diabetic neuropathy: a double-blind cross-over study . Pain. 1985;23:395-400.Crossref 5. Dejgard A, Peterson P, Kastrup J. Mexiletine for treatment of chronic painful diabetic neuropathy . Lancet. 1988;1:9-11.Crossref 6. Kvinesdal B, Molin J, Froland A, Gram LF. Imipramine treatment of painful diabetic neuropathy . JAMA. 1984;251:1727-1730.Crossref 7. Max MB, Culnane M, Schafer SC, et al. Amitriptyline relieves diabetic neuropathy pain in patients with normal or depressed mood . Neurology. 1987;37:589-596.Crossref 8. Watson CPN, Evans RJ, Watt VR. Post-herpetic neuralgia and topical capsaicin . Pain. 1988;33:333-400.Crossref 9. Bernstein JE, Bickers DR, Dahl MV, Roshal JY. Treatment of chronic postherpetic neuralgia with topical capsaicin . J Am Acad Dermatol. 1987;17:93-96.Crossref 10. Bernstein JE, Korman NJ, Bickers DR, Dahl MV, Millikan LE. Topical capsaicin treatment of chronic postherpetic neurolgia . J Am Acad Dermatol. 1989;21:265-270.Crossref 11. Watson CPN, Evans RJ, Watt VR. The post-mastectomy pain syndrome and the effect of topical capsaicin . Pain. 1989;38:177-186.Crossref 12. Fitzgerald M. Capsaicin and sensory neurons: a review . Pain. 1983;15:109-130.Crossref 13. Lynn B. Capsaicin: actions on nociceptive C-fibres and therapeutic potential . Pain. 1990;41:61-69.Crossref 14. Kenins P. Responses of single nerve fibres to capsaicin applied to the skin . Neurosci Lett. 1982;29:83-88.Crossref 15. Gamse R, Petsche U, Lembeck F, Jancso G. Capsaicin applied to peripheral nerve inhibits axoplasmic transport of substance P and somatostatin . Brain Res. 1982;239:447-462.Crossref 16. Gowdey CW. A guide to the pharmacology of placebos . Can Med Assoc J. 1983;128:921-925. 17. Nielsen PG. Treatment of rosacea with 1% metronidazole cream: a double-blind study . Br J Dermatol. 1983;108:327-332.Crossref 18. Tandan R, Lewis G, Fries T. Safety of topical capsaicin in diabetic neuropathy . Neurology. 1990;40( (suppl) ):160. Abstract.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1991

References