CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet

Introduction Painful diabetic peripheral neuropathy (pDPN), a common complication of diabetes, is challenging to treat and negatively impacts quality of life (QoL). Many patients either fail to achieve adequate pain relief with current treatments or suffer from systemic side effects with oral option...

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Main Authors: Michael Überall, Mariëlle Eerdekens, Tamara Quandel, Sylvia Engelen, Lucia Garcia-Guerra, Tawfik Fajri, Samuel Allen, Rita Freitas, Zoltan Kender
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/13/3/e004864.full
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author Michael Überall
Mariëlle Eerdekens
Tamara Quandel
Sylvia Engelen
Lucia Garcia-Guerra
Tawfik Fajri
Samuel Allen
Rita Freitas
Zoltan Kender
author_facet Michael Überall
Mariëlle Eerdekens
Tamara Quandel
Sylvia Engelen
Lucia Garcia-Guerra
Tawfik Fajri
Samuel Allen
Rita Freitas
Zoltan Kender
author_sort Michael Überall
collection DOAJ
description Introduction Painful diabetic peripheral neuropathy (pDPN), a common complication of diabetes, is challenging to treat and negatively impacts quality of life (QoL). Many patients either fail to achieve adequate pain relief with current treatments or suffer from systemic side effects with oral options. This study used data from the German Pain e-Registry (GPeR) to evaluate the high-concentration capsaicin topical system (HCCTS) for treating pDPN of the feet.Research design and methods This retrospective, non-interventional cohort study (CASPAR) included patients with pDPN of the feet who received ≥1 HCCTS treatment (~3-month treatment intervals) and contributed data to the GPeR for ≥12 months. Data were collected on pain intensity, QoL, sleep, mood, concomitant medication, and tolerability.Results Overall, 365 patients with pDPN of the feet were included. Significant reductions in 24-hour average pain intensity (API) were observed from baseline to month 3 (following one HCCTS treatment). Further reductions in mean API score were seen over 12 months with ongoing treatments, whereas API increased in patients who discontinued treatment (baseline to month 12 mean API scores: 61.4 to 8.8 for four HCCTS [∆ −52.6], 59.3 to 16.7 for three HCCTS [∆ −42.6], 56.3 to 31.9 for two HCCTS [∆ −24.4], 57.5 to 51.4 for one HCCTS [∆ −6.1]). Similar trends were seen for sleep, mood, and QoL outcomes. There was a significant reduction in concomitant pain medication use in patients receiving ongoing HCCTS treatments. The most common adverse events were local application-site reactions.Conclusions This real-world study in patients with pDPN of the feet demonstrates that ongoing HCCTS treatments continue to improve pain intensity, mood, and QoL, while concomitant medication use decreases. Benefits from treatment were lost following HCCTS discontinuation. These findings emphasize the importance of ongoing treatments to achieve the potential of HCCTS in improving outcomes for patients with pDPN.
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spelling doaj-art-dd46ffdc61a44c049d1ced8d305581af2025-08-20T02:15:08ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972025-05-0113310.1136/bmjdrc-2024-004864CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feetMichael Überall0Mariëlle Eerdekens1Tamara Quandel2Sylvia Engelen3Lucia Garcia-Guerra4Tawfik Fajri5Samuel Allen6Rita Freitas7Zoltan Kender8Institute of Neurological Sciences, Nürnberg, GermanyGrünenthal GmbH, Aachen, GermanyGrünenthal GMBH, Aachen, GermanyGrünenthal GMBH, Aachen, GermanyGrünenthal Pharma SA, Madrid, SpainLaboratoires Grünenthal SAS, Paris, FranceAveritas Pharma, Morristown, New Jersey, USAGrünenthal SA, Lisbon, PortugalDepartment for Endocrinology, Diabetology, Metabolic Diseases and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, GermanyIntroduction Painful diabetic peripheral neuropathy (pDPN), a common complication of diabetes, is challenging to treat and negatively impacts quality of life (QoL). Many patients either fail to achieve adequate pain relief with current treatments or suffer from systemic side effects with oral options. This study used data from the German Pain e-Registry (GPeR) to evaluate the high-concentration capsaicin topical system (HCCTS) for treating pDPN of the feet.Research design and methods This retrospective, non-interventional cohort study (CASPAR) included patients with pDPN of the feet who received ≥1 HCCTS treatment (~3-month treatment intervals) and contributed data to the GPeR for ≥12 months. Data were collected on pain intensity, QoL, sleep, mood, concomitant medication, and tolerability.Results Overall, 365 patients with pDPN of the feet were included. Significant reductions in 24-hour average pain intensity (API) were observed from baseline to month 3 (following one HCCTS treatment). Further reductions in mean API score were seen over 12 months with ongoing treatments, whereas API increased in patients who discontinued treatment (baseline to month 12 mean API scores: 61.4 to 8.8 for four HCCTS [∆ −52.6], 59.3 to 16.7 for three HCCTS [∆ −42.6], 56.3 to 31.9 for two HCCTS [∆ −24.4], 57.5 to 51.4 for one HCCTS [∆ −6.1]). Similar trends were seen for sleep, mood, and QoL outcomes. There was a significant reduction in concomitant pain medication use in patients receiving ongoing HCCTS treatments. The most common adverse events were local application-site reactions.Conclusions This real-world study in patients with pDPN of the feet demonstrates that ongoing HCCTS treatments continue to improve pain intensity, mood, and QoL, while concomitant medication use decreases. Benefits from treatment were lost following HCCTS discontinuation. These findings emphasize the importance of ongoing treatments to achieve the potential of HCCTS in improving outcomes for patients with pDPN.https://drc.bmj.com/content/13/3/e004864.full
spellingShingle Michael Überall
Mariëlle Eerdekens
Tamara Quandel
Sylvia Engelen
Lucia Garcia-Guerra
Tawfik Fajri
Samuel Allen
Rita Freitas
Zoltan Kender
CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
BMJ Open Diabetes Research & Care
title CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
title_full CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
title_fullStr CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
title_full_unstemmed CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
title_short CASPAR: a retrospective cohort study of the high-concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
title_sort caspar a retrospective cohort study of the high concentration capsaicin topical system in patients with painful diabetic peripheral neuropathy of the feet
url https://drc.bmj.com/content/13/3/e004864.full
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