Topical capsaicin in the management of HIV-associated peripheral neuropathy

Distal symmetrical peripheral neuropathy (DSPN) is a particularly distressi ng pain syndrome associated with human immunodeficiency virus (HIV) disease . Capsaicin has been found to be effective in relieving pain associated wit h other neuropathic pain syndromes, and is mentioned as a possible topical adjuvant analgesic for the relief of DSPN. This multicenter; controlled, ra ndomized, double-masked clinical trial studied patients with HIV-associated DSPN and compared measures of pain intensity, pain relief, sensory percept ion, quality of life, mood, and function for patients who received topical capsaicin to the corresponding measures for patients who received the vehic le only. Twenty-six subjects were enrolled in the study. At the end of 1 we ek, subjects receiving capsaicin tended to report higher current pain score s than did subjects receiving the vehicle (Mann-Whitney test; P = 0.042). T he dropout rate was higher for the capsaicin group (67%) than for the vehic le group (18%) (chi(2) test of association; P = 0.014). there were no other statistically significant differences between the capsaicin and vehicle gr oups with respect to current pain, worst pain, pain relief, sensory percept ion, quality of life, mood, or function at study entry or at any time durin g the 4-week trial. These results suggest capsaicin is the ineffective in r elieving pain associated with HIV-associated DSPN. (C) U.S. Cancer Pain Rel ief Committee, 2000.