Nutzen und Wirtschaftlichkeit der Topischen Behandlung Peripherer Neuropathischer Schmerzen mit dem Capsaicin-Pflaster Qutenza – ein Literaturüberblick

Zusammenfassung

Hintergrund Periphere Neuropathien sind häufig und beeinträchtigen die Lebensqualität der PatientInnen erheblich. Die Behandlung ist komplex und kann, in Abhängigkeit von der Grunderkrankung, bei vielen PatientInnen keine vollständige Beschwerdefreiheit erzielen. Eine Therapieoption ist hochdosiertes Capsaicin 179 mg (oder 8%) in Form eines kutanen Pflasters (Qutenza). Die vorliegende Literaturübersicht soll eine Einschätzung zu Nutzen und Kosten dieser Therapie, auch im Vergleich zu systemischer Medikation, bieten.

Methodik In der bibliografischen Datenbank PubMed wurde eine strukturierte Literaturrecherche durchgeführt, um relevante Publikationen zur topischen Therapie peripherer neuropathischer Schmerzen mit dem hochdosierten Capsaicin-Pflaster zu identifizieren und hinsichtlich ihres Nutzens sowie unter ökonomischen Gesichtspunkten zu bewerten. Die Ergebnisse der eingeschlossenen Publikationen wurden extrahiert und narrativ zusammengefasst.

Ergebnisse Es wurden insgesamt 29 Artikel in die Auswertung einbezogen. In acht randomisierten kontrollierten Studien konnte die Wirksamkeit einer Behandlung peripherer neuropathischer Schmerzen unterschiedlicher Genese mit hochdosiertem Capsaicin in Form eines kutanen Pflasters belegt werden. Das Capsaicin-Pflaster führte gegenüber der Standard-Therapie zu einer vergleichbaren Reduktion der neuropathischen Schmerzsymptome bei deutlich geringeren Nebenwirkungen. Für den Bereich der Wirtschaftlichkeit konnten nur drei Publikationen ermittelt werden, die jedoch nicht das deutsche Gesundheitssystem berücksichtigen. Die drei Analysen kommen zu dem Schluss, dass die topische Capsaicin-Therapie im Vergleich zu den jeweils untersuchten systemisch wirksamen Vergleichspräparaten kosteneffektiv ist.

Schlussfolgerung Es konnte für periphere neuropathische Schmerzen unterschiedlicher Genese der Nutzen einer topischen Behandlung mit dem kutanen Capsaicin-Pflaster Qutenza nachgewiesen werden. In Bezug auf die Wirtschaftlichkeit dieser Therapieoption, besonders in Hinblick auf das deutsche Gesundheitssystem, sind weitere Analysen notwendig.

Abstract

Background Peripheral neuropathies are common and have a significant impact on patients’ quality of life. Their treatment is complex and, depending on the underlying disease, may not provide complete relief for many patients. One treatment option is high-dose capsaicin 179 mg (or 8%) as a cutaneous patch (Qutenza). This literature review is intended to provide an assessment of the benefits and costs of this therapy, also in comparison to systemic medication.

Methods A structured literature search was conducted in the PubMed bibliographic database to identify relevant publications on the topical therapy of peripheral neuropathic pain with the high-dose capsaicin patch and to evaluate them with regard to their benefit and from an economic point of view. The results of the included publications were extracted and summarised.

Results A total of 29 articles were included in the evaluation. In eight randomised controlled trials, the efficacy of treating peripheral neuropathic pain of various origins with high-dose capsaicin as a cutaneous patch was proven. Compared to standard therapy, the capsaicin patch led to a comparable reduction in neuropathic pain symptoms with significantly fewer side effects. For the area of cost-effectiveness, only three publications could be identified, which, however do not consider the German health care system. All three analyses conclude that topical capsaicin therapy is cost-effective compared to the systemic comparative therapy examined in each case.

Conclusion The benefit of a topical treatment with the capsaicin 179 mg cutaneous patch could be proven for peripheral neuropathic pain of various origins. Further analyses are necessary regarding the cost-effectiveness of this therapy option, especially with regard to the German health care system.

Schlüsselwörter

Capsaicin - Neuropathie - peripherer neuropathischer Schmerz - Literaturübersicht

Key words

Capsaicin - neuropathy - peripheral neuropathic pain - literature review

Publication History

Article published online:
25 March 2022

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