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The Efficacy of topical Capsaicin in the management of painful diabetic peripheral neuropathy: A unicenter double-blind, randomized clinical trial

Article scientifique 2020 Anglais

Résumé

Abstract Background: Painful peripheral neuropathy is a common complication of diabetes and its management is difficult. Neurotropic drugs, which are the drugs of choice, have moderate efficacy due to high first pass metabolism. Topical Capsaicin, derived from the capsicum plant, is effective in relieving the pain of diabetic peripheral neuropathy in Caucasians. Due to an intercultural bias in pain treatment response, we evaluated the efficacy of Capsaicin on painful diabetic neuropathy in sub-Saharan subjectsMethods: 22 subjects with type 2 diabetes having painful diabetic polyneuropathy were randomly assigned using a 1:1 blocking pattern, with parallel design, to an intervention group of capsaicin cream, or to a control group of Miconazole cream. Participants and investigators were blinded to the randomization. Both groups applied the supplied drug topically three times daily for 08 weeks. Pain intensity was noted in both groups, using a visual analogue scale, at intervals of 2 weeks. The trial took place at the national obesity center in Cameroon. The primary analysis was intention-to-treat, and compared the reduction in the mean pain score from baseline, per 2 week period.Results: Twenty-two patients, aged 55 ± 7 years, with an average pain intensity of 6.3 units in the Capsaicin group and 5.8 units in the placebo group were included; at inclusion, there was no significant difference in the 2 groups (p=0.52). After 02 weeks, the mean value of pain intensity was 3.3±0.9 vs 5.4±1.7 (p=0.004), at week 4, 3.2±0.9 vs 4.7±1.2 (p=0,015), at week 6, 3.5±1.3 vs 4.8±1.3 (p=0.018) and at week 8, 6.6±1.1 vs 5.4±1.0 (p=0.55) for capsaicin and placebo respectively. The main side effect in the capsaicin group was burning sensations in the application zonesConclusion: Capsaicin significantly reduced neuropathic pain in the intervention group; however the pain worsened at week 8. It therefore has a transient positive effect on neuropathic pain in sub-Saharan subjects

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Agoons, B., Dehayem, M., Etoga, M., Agoons, D., Yepnjio, F., Boli, A., Wasnyo, Y., Katte, J., Ngassam, E., Nkamgna, A., Sobngwi, E., Mbanya, J. (2020). The Efficacy of topical Capsaicin in the management of painful diabetic peripheral neuropathy: A unicenter double-blind, randomized clinical trial. https://doi.org/10.21203/rs.3.rs-19190/v1

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Batakeh B. Agoons Mesmin Dehayem Martine Claude Etoa Etoga Dayawa D. Agoons Faustin N. Yepnjio Anne Ongmeb Boli Yves Wasnyo Jean-Claude Katte E. Ngassam Ariane Nkamgna Eugène Sobngwi Jean Claude Mbanya

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