Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain

John F Peppin1, Kristine Majors2, Lynn R Webster3, David M Simpson4, Jeffrey K Tobias5, Geertrui F Vanhove51The Pain Treatment Center of the Bluegrass, Lexington, KY, USA; 2Integrated Clinical Trial Services, Inc, West Des Moines, IA, USA; 3Lifetree Clinical Research and Pain Clinic, Salt Lake City,...

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Main Authors: Peppin JF, Majors K, Webster LR, Simpson DM, Tobias JK, Vanhove GF
Format: Article
Language:English
Published: Dove Medical Press 2011-11-01
Series:Journal of Pain Research
Online Access:http://www.dovepress.com/tolerability-of-ngx-4010-a-capsaicin-8-patch-for-peripheral-neuropathi-a8652
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author Peppin JF
Majors K
Webster LR
Simpson DM
Tobias JK
Vanhove GF
author_facet Peppin JF
Majors K
Webster LR
Simpson DM
Tobias JK
Vanhove GF
author_sort Peppin JF
collection DOAJ
description John F Peppin1, Kristine Majors2, Lynn R Webster3, David M Simpson4, Jeffrey K Tobias5, Geertrui F Vanhove51The Pain Treatment Center of the Bluegrass, Lexington, KY, USA; 2Integrated Clinical Trial Services, Inc, West Des Moines, IA, USA; 3Lifetree Clinical Research and Pain Clinic, Salt Lake City, UT, USA; 4Mount Sinai Medical Center, New York, NY, USA; 5NeurogesX, Inc, San Mateo, CA, USABackground/purpose: NGX-4010 (QUTENZA™; NeurogesX Inc, San Mateo, CA), a capsaicin 8% dermal patch, is licensed in the European Union for the treatment of peripheral neuropathic pain (PNP) in nondiabetic adults and in the United States for the treatment of neuropathic pain associated with postherpetic neuralgia (PHN). While NGX-4010 treatment is associated with a low risk of systemic adverse events, patch application-related pain is common and may be managed with local cooling and/or oral analgesics. This article characterizes the tolerability of NGX-4010 and will help to guide any pain management.Methods: This integrated analysis of tolerability data collected from the NGX-4010 clinical study program included 1696 patients with PNP. Patch application-related pain on the treatment day was captured as Numeric Pain Rating Scale (NPRS) “pain now” scores while “average pain for the past 24 hours” NPRS scores were analyzed for 7 days following treatment. Other tolerability assessments included the percentage of patients completing ≥90% of the intended treatment duration and patients using medication for patch application-related pain.Results: The mean maximum change in “pain now” NPRS scores from pretreatment levels during and after patch application was 2.6 for all patients. This pain was transient and resolved following patch removal. Mean “average pain for the past 24 hours” NPRS scores returned to baseline by the evening of the treatment day for patients with PHN, and the evening of day 2 for patients with human immunodeficiency virus-associated distal sensory polyneuropathy or painful diabetic neuropathy. Repeated NGX-4010 applications did not affect the intensity of patch application-related pain. Almost all patients (≥98%) completed ≥90% of the full treatment duration, regardless of the number of treatments received.Conclusion: Transient patch application-related pain with NGX-4010 can be managed with local cooling and/or oral analgesics in nearly all cases. Patient adherence to the full intended treatment duration indicated that patch application-related pain was not a barrier to NGX-4010 use.Keywords: capsaicin 8% patch, NGX-4010, patch application-related pain, neuropathic pain
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spelling doaj.art-29b67a6a2ac04bcd8a466a4afef2a5762022-12-22T02:43:27ZengDove Medical PressJournal of Pain Research1178-70902011-11-012011default385392Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic painPeppin JFMajors KWebster LRSimpson DMTobias JKVanhove GFJohn F Peppin1, Kristine Majors2, Lynn R Webster3, David M Simpson4, Jeffrey K Tobias5, Geertrui F Vanhove51The Pain Treatment Center of the Bluegrass, Lexington, KY, USA; 2Integrated Clinical Trial Services, Inc, West Des Moines, IA, USA; 3Lifetree Clinical Research and Pain Clinic, Salt Lake City, UT, USA; 4Mount Sinai Medical Center, New York, NY, USA; 5NeurogesX, Inc, San Mateo, CA, USABackground/purpose: NGX-4010 (QUTENZA™; NeurogesX Inc, San Mateo, CA), a capsaicin 8% dermal patch, is licensed in the European Union for the treatment of peripheral neuropathic pain (PNP) in nondiabetic adults and in the United States for the treatment of neuropathic pain associated with postherpetic neuralgia (PHN). While NGX-4010 treatment is associated with a low risk of systemic adverse events, patch application-related pain is common and may be managed with local cooling and/or oral analgesics. This article characterizes the tolerability of NGX-4010 and will help to guide any pain management.Methods: This integrated analysis of tolerability data collected from the NGX-4010 clinical study program included 1696 patients with PNP. Patch application-related pain on the treatment day was captured as Numeric Pain Rating Scale (NPRS) “pain now” scores while “average pain for the past 24 hours” NPRS scores were analyzed for 7 days following treatment. Other tolerability assessments included the percentage of patients completing ≥90% of the intended treatment duration and patients using medication for patch application-related pain.Results: The mean maximum change in “pain now” NPRS scores from pretreatment levels during and after patch application was 2.6 for all patients. This pain was transient and resolved following patch removal. Mean “average pain for the past 24 hours” NPRS scores returned to baseline by the evening of the treatment day for patients with PHN, and the evening of day 2 for patients with human immunodeficiency virus-associated distal sensory polyneuropathy or painful diabetic neuropathy. Repeated NGX-4010 applications did not affect the intensity of patch application-related pain. Almost all patients (≥98%) completed ≥90% of the full treatment duration, regardless of the number of treatments received.Conclusion: Transient patch application-related pain with NGX-4010 can be managed with local cooling and/or oral analgesics in nearly all cases. Patient adherence to the full intended treatment duration indicated that patch application-related pain was not a barrier to NGX-4010 use.Keywords: capsaicin 8% patch, NGX-4010, patch application-related pain, neuropathic painhttp://www.dovepress.com/tolerability-of-ngx-4010-a-capsaicin-8-patch-for-peripheral-neuropathi-a8652
spellingShingle Peppin JF
Majors K
Webster LR
Simpson DM
Tobias JK
Vanhove GF
Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain
Journal of Pain Research
title Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain
title_full Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain
title_fullStr Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain
title_full_unstemmed Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain
title_short Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain
title_sort tolerability of ngx 4010 a capsaicin 8 patch for peripheral neuropathic pain
url http://www.dovepress.com/tolerability-of-ngx-4010-a-capsaicin-8-patch-for-peripheral-neuropathi-a8652
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