Comment on: "Treating Pain in Diabetic Neuropathy: Current and Developmental Drugs"/Response

• Published in: Drugs (New York, N.Y.) N.Y.), 2020-07, Vol.80 (11), p.1139-1143
• Main Authors: Eerdekens, M, Stupar, M, Marcondes, L
• Format: Article
• Language: English
• Subjects: Biopsy; Capsaicin; Diabetes; Diabetes mellitus; Diabetic neuropathy; FDA approval; Older people; Pain; Physicians; Side effects; Sleep
• ISSN: 0012-6667; 1179-1950
• DOI: 10.1007/s40265-020-01353-5

In Sect. 5.13.3, "Topical Treatment with Capsaicin", in contrast with similar sections covering oral treatments, there is no elaboration on the benefits of topical capsaicin and, more specifically, HCCP. [...]this section does not differentiate between HCCP and low-dose capsaicin creams, which might result in significant misperceptions. [5] showed that the average daily pain score from baseline to weeks 2-12 reduced significantly (P = 0.018) with HCCP compared with placebo (mean ± standard deviation 28.0 ± 27.3% vs. 21.0 ± 29.4%, respectively). [...]a greater mean percentage reduction in Brief Pain Inventory-Diabetic Neuropathy sleep interference numeric pain rating scale score was seen with HCCP versus placebo from baseline to weeks 2-12 (P = 0.020 for weeks 2-12). Local treatments such as HCCP are valid alternatives given that they are devoid of such side effects because of their limited systemic absorption. [...]as older patients are often poly-medicated, the risk of drug-drug interactions is increased with oral therapy, and this is largely avoided with topical treatments for the same reason. [...]we believe it is important for all currently available treatments to be presented fairly in a state-of-the-art summary of the treatment of pDPN so physicians can make informed decisions about the best treatment options for individual patients.