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Qutenza (Capsaicin) 8% Patch Onset and Duration of Response and Effects of Multiple Treatments in Neuropathic Pain Patients

Mou, Joy MPH*; Paillard, Florence PhD; Turnbull, Barry PhD‡,§; Trudeau, Jeremiah PhD*; Stoker, Malcolm PhD; Katz, Nathaniel P. MD, MS*

doi: 10.1097/AJP.0b013e31829a4ced
Original Articles

Introduction: Qutenza (capsaicin) 8% patch is used to treat various neuropathic indications, including postherpetic neuralgia (PHN) and human immunodeficiency virus-associated neuropathy (HIV-AN).

Objectives: We conducted a meta-analysis of Qutenza studies to describe clinical phenomena of effects of Qutenza treatment better, such as onset and duration of pain relief, and the need for retreatments.

Methods: The meta-analyses combined individual patient data (1313 participants with PHN and 801 with HIV-AN) from 7 completed randomized, double-blind, controlled studies. Studies had similar designs, and all used the Qutenza patch (8% capsaicin) and a low-dose control patch (0.04% capsaicin). A 30% response was defined as a ≥30% decrease in mean pain intensity score during week 2 to end of follow-up; complete pain relief was defined as an average pain intensity ≤1 during week 2 to end of follow-up. Duration of response was calculated using the data from long-term studies as the time from onset of response to offset of response, retreatment, or end of follow-up (whichever occurred first).

Results: Overall 44% of PHN and 41% of HIV-AN patients had a 30% response, and 11% and 7%, respectively, had complete pain relief 2 to 12 weeks after treatment with Qutenza. The mean (median) onset of response to Qutenza was 3.4 (1) days for PHN and 6.5 (4) days for HIV-AN (delayed due to an initial increase in discomfort). The mean (median) duration of response after 1 Qutenza treatment was 5 (3) months. Of the patients followed-up for 12 months, 40% PHN and 36% HIV-AN patients had a 30% response, and 9% and 10%, respectively, had complete pain relief from week 2 to end of follow-up.

Conclusions: Qutenza is effective in a high proportion of patients. In patients who respond to Qutenza, analgesia starts within a few days of treatment and lasts on average 5 months.

*Analgesic Solutions, Natick

LLX Solutions, Watertown

§Biobridges, Wellesley, MA

FocusBiocom, Durango, CO

Astellas Pharma Global Development, Leiderdorp, The Netherlands

Supported by Astellas Pharma Global Development (Leiderdorp, the Netherlands). The authors declare no conflict of interest.

Reprints: Nathaniel P. Katz, MD, MS, Analgesic Solutions, 232 Pond Street, Natick, MA 01760 (e-mail:

Received January 28, 2013

Accepted April 26, 2013

© 2014 by Lippincott Williams & Wilkins