High-Concentration Capsaicin Patch and Oral Pregabalin as Second-Line Therapy for Intercostobrachial Neuralgia After Breast Cancer Surgery: Open-Label Follow-Up of a Multicenter Randomized Controlled Clinical Trial.
Most capsaicin patch responders chose to repeat it rather than switch to pregabalin
High-Concentration Capsaicin Patch and Oral Pregabalin as Second-Line Therapy for Intercostobrachial Neuralgia After Breast Cancer Surgery: Open-Label Follow-Up of a Multicenter Randomized Controlled Clinical Trial.
The CAPTRANE trial evaluated the efficacy of randomly assigned high-concentration capsaicin patch (high-concentration capsaicin patch) versus daily oral pregabalin (pregabalin) in adults with chronic neuropathic pain (DN4 ≥ 4) post-breast cancer surgery.
The objective of its 4-month open-label extension following patient's self-selection of their second treatment (high-concentration capsaicin patch, pregabalin, or none) was to explore efficacy and safety of various strategies.
At each clinic visit, we assessed pain intensity (NRS, 0-10), painful area (cm 2 ), mood (HADS), and quality of life (EQ-5D-5L).
At Month 6, NRS scores had decreased in high-concentration capsaicin patch-treated patients, including pregabalin/high-concentration capsaicin patch-treated patients, with a reduction of -2.0 [-4.0; 0.0] and -3.0 [-4.0; -2.0] in the high-concentration capsaicin patch/high-concentration capsaicin patch and pregabalin/high-concentration capsaicin patch group, respectively (median[interquartile]).
Adverse events aligned with those expected with high-concentration capsaicin patch and pregabalin; none were serious.
This first study to examine switching between pregabalin and high-concentration capsaicin patch treatments for chronic intercostobrachial neuropathic pain after breast cancer surgery showed patients' preference for high-concentration capsaicin patch, confirmed the benefit of repeated high-concentration capsaicin patch applications, and indicated that high-concentration capsaicin patch could be preceded by pregabalin without compromising efficacy or safety.
These findings suggest that high-concentration capsaicin patch may be used early in this population, and pregabalin initiated before high-concentration capsaicin patch to relieve patients waiting for high-concentration capsaicin patch application.