Division of Neurology, Imperial College London, Hammersmith Hospital, London, UK.
Curr Opin Support Palliat Care. 2021 Jun 1;15(2):125-131. doi: 10.1097/SPC.0000000000000545.
PURPOSE OF REVIEW: Current oral treatments for neuropathic pain associated with chemotherapy-induced peripheral neuropathy (CIPN) have limited clinical efficacy, and undesirable side-effects. Topically delivered treatments have the advantage of avoiding CNS side-effects, while relieving pain. We have reviewed treatments of neuropathic pain associated with CIPN, focusing on the Capsaicin 8% patch, which can provide pain relief for up to 3 months or longer after a single 30-60-min application. RECENT FINDINGS: Capsaicin 8% patch is a licensed treatment in the EU/UK for neuropathic pain and shown to be safe and effective in providing pain relief for patients with CIPN. Repeated daily oral or topical administrations are not required, as with other current treatments. The side-effects are transient and restricted to the time around patch application. New evidence suggests the Capsaicin 8% patch can promote the regeneration and restoration of skin nerve fibres in CIPN, in addition to the pain relief. SUMMARY: The Capsaicin 8% patch is now often a preferred a treatment option for localised neuropathic pain conditions, including the feet and hands in patients with CIPN. Capsaicin 8% patch can be repeated three-monthly, if needed, for a year. In addition to pain relief, it may have a disease-modifying effect.
目的综述:目前用于治疗化疗引起的周围神经病变性疼痛(CIPN)的口服药物疗效有限,且有不良反应。局部给药的优点是可以避免中枢神经系统的副作用,同时缓解疼痛。我们回顾了与 CIPN 相关的神经病理性疼痛的治疗方法,重点介绍了 8%辣椒素贴片,单次使用 30-60 分钟后,其止痛效果可持续长达 3 个月或更长时间。
最新研究进展:8%辣椒素贴片在欧盟/英国被批准用于治疗神经病理性疼痛,并且已被证明对 CIPN 患者的疼痛缓解安全有效。与其他当前治疗方法不同,不需要每日重复口服或局部使用。其副作用是短暂的,仅局限于贴片应用期间。新证据表明,8%辣椒素贴片除了缓解疼痛外,还可以促进 CIPN 中皮肤神经纤维的再生和修复。
总结:8%辣椒素贴片现在通常是局部神经病理性疼痛(包括 CIPN 患者手部和足部疼痛)的首选治疗方法。如果需要,该贴片可每 3 个月重复使用一次,持续 1 年。除了缓解疼痛外,它可能还有疾病修饰作用。
Curr Opin Support Palliat Care. 2021-6-1
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