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Capsaicin for Osteoarthritis Pain

Citation

Laslett, LL and Jones, G, Capsaicin for Osteoarthritis Pain, Capsaicin as a Therapeutic Molecule, Springer, Abdel-Salam, Omar M.E (ed), Basel, pp. 277-291. ISBN 978-3-0348-0828-6 (2014) [Research Book Chapter]

Copyright Statement

Copyright 2014 Springer Basel

DOI: doi:10.1007/978-3-0348-0828-6_11

Abstract

Capsaicin appears to be effective for osteoarthritis pain but it is uncertain whether the effect has a dose response, is consistent across joints, or changes over time. Methods: Randomized controlled trials of topical capsaicin use in OA were identified from PubMed, EMBASE, and ISI Web of Knowledge. Effect on pain scores, patient global evaluation of treatment effectiveness and application site burning were assessed by standardised mean differences (SMD), using RevMan. Results: Five double–blind randomized controlled trials and one case–crossover trial of topical capsaicin use were identified. Formulations ranged from 0.025 to 0.075 %, and trial durations from 4 to 12 weeks. Trials assessed OA of the knee (n = 3), hand (n = 1), and a mix of joints (n = 2). Capsaicin treatment efficacy (vs. placebo) for change in VAS pain score was moderate, at 0.44 (95 % CI 0.25–0.62) over 4 weeks of treatment. There was no heterogeneity between studies, indicating no betweenstudy differences, including effect of OA site or treatment concentration. Two studies reported treatment beyond 4 weeks, with divergent results. One study reported an effect size of −9 mm after 12 weeks, and maximal between-group differences at 4 weeks. A second study reported that between-group differences increased over time, up to 20 weeks. Capsaicin was reported as being safe and well–tolerated, with no systemic toxicity. Mild application site burning affected 35–100 % of capsaicin– treated patients with a risk ratio of 4.22 (95 % CI 3.25–5.48, n = 5 trials); incidence peaked in week 1, with incidence rates declining over time. Conclusions: Topical capsaicin treatment four times daily is moderately effective in reducing pain intensity up to 20 weeks regardless of site of application and dose in patients with at least moderate pain and clinical or radiologically defined OA, and is well tolerated.

Item Details

Item Type:Research Book Chapter
Keywords:osteoarthritis; arthritis; pain; capsaicin
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
Author:Laslett, LL (Dr Laura Laslett)
Author:Jones, G (Professor Graeme Jones)
ID Code:92389
Year Published:2014
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-06-17
Last Modified:2018-03-05
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