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@article{Anand:2022:10.3389/fneur.2022.998904,
author = {Anand, P and Privitera, R and Donatien, P and Fadavi, H and Tesfaye, S and Bravis, V and Misra, VP},
doi = {10.3389/fneur.2022.998904},
journal = {Frontiers in Neurology},
title = {Reversing painful and non-painful diabetic neuropathy with the capsaicin 8% patch: Clinical evidence for pain relief and restoration of function via nerve fiber regeneration},
url = {http://dx.doi.org/10.3389/fneur.2022.998904},
volume = {13},
year = {2022}
}

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TY  - JOUR
AB  - Introduction: Current oral treatments for pain in diabetic peripheral neuropathy (DPN) do not affect the progression of DPN i.e.“disease modification”. We assessed whether Capsaicin 8% patch treatment can provide pain relief and also restore nerve densityand function via nerve regeneration, in both painful (PDPN) and non-painful (NPDPN) diabetic peripheral neuropathy.Methods: 50 participants with PDPN were randomized to receive Capsaicin 8% patch Qutenza with Standard of Care (SOC) (PDPNQ+SOC group), or SOC alone (PDPN SOC group). Pain symptoms were assessed with a diary (Numerical Pain Rating Scale, NRPS) andquestionnaires. Investigations included quantitative sensory testing (QST) and distal calf skin biopsies, at baseline and 3 monthsafter baseline visit; subsequent options were 3-monthly visits over 1 year. 25 participants with NPDPN had tests at baseline, and3 months after all received Capsaicin 8% patch treatment.Results: At 3 months after baseline, PDPN Q+SOC group had reduction in NPRS score (p=0.0001), but not PDPN SOC group.Short-Form McGill Pain Questionnaire (SF-MPQ) showed significant reductions in scores for overall and other pain descriptors onlyin the PDPN Q+SOC group. Warm perception thresholds were significantly improved only in the PDPN Q+SOC group (p=0.02), andcorrelated with reduction in SF-MPQ overall pain score (p=0.04). NPDPN Q+SOC group did not report pain during the entire study.Density of intra-epidermal nerve fibres (IENF) with PGP9.5 was increased at 3 months in PDPN Q+SOC (p=0.0002) and NPDPN Q+SOC(p=0.002) groups, but not in the PDPN SOC group. Increased sub-epidermal nerve fibres (SENF) were observed with GAP43 (markerof regenerating nerve fibres) only in PDPN Q+SOC (p=0.003) and NPDPN Q+SOC (p=0.0005) groups. Pain relief in the PDPN Q+SOCgroup was correlated with the increased PGP9.5 IENF (p=0.0008) and GAP43 (p=0.004), whereas those with lack of pain reliefshowed no such increase; in some subjects pain relief and increas
AU  - Anand,P
AU  - Privitera,R
AU  - Donatien,P
AU  - Fadavi,H
AU  - Tesfaye,S
AU  - Bravis,V
AU  - Misra,VP
DO  - 10.3389/fneur.2022.998904
PY  - 2022///
SN  - 1664-2295
TI  - Reversing painful and non-painful diabetic neuropathy with the capsaicin 8% patch: Clinical evidence for pain relief and restoration of function via nerve fiber regeneration
T2  - Frontiers in Neurology
UR  - http://dx.doi.org/10.3389/fneur.2022.998904
UR  - http://hdl.handle.net/10044/1/100432
VL  - 13
ER  -

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