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Capsaicin for Osteoarthritis Pain

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posted on 2023-05-22, 15:07 authored by Laura LaslettLaura Laslett, Graeme JonesGraeme Jones
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.

Funding

Arthritis Australia

History

Publication title

Capsaicin as a Therapeutic Molecule

Volume

68

Editors

Abdel-Salam, Omar M.E

Pagination

277-291

ISBN

978-3-0348-0828-6

Department/School

Menzies Institute for Medical Research

Publisher

Springer

Place of publication

Basel

Extent

13

Rights statement

Copyright 2014 Springer Basel

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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