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Analgesic Effectiveness of Capsaicin 8% Cutaneous Patch in Children

Phase 3
Recruiting
Conditions
Neuropathic Pain
Chronic Pain
Interventions
Device: Hydrocolloid dressing
Registration Number
NCT05997979
Lead Sponsor
University Hospital, Brest
Brief Summary

This study concerns children aged to 12 to 17-years with local chronic neuropathic pain after trauma or surgery.

It is a multicentric randomized controlled superiority trial in parallel arms :

* experimental arm: Capsaicin 8% cutaneous patch

* controlled arm : Hydrocolloid dressing

Treatment with capsaicin application is realized at baseline, and repeated 3 months after the first patch application if needed.

Tolerance is assessed during each application and by phone call in following days until stop of cold need.

Efficacy is assessed monthly by clinical consultation until the end of the study (month 4).

Detailed Description

Children aged to 12 to 17-years monitored in pediatric pain outpatient clinics in the designed investigation centers for a local chronic neuropathic pain lasting more than 2 months after trauma or surgery are proposed to participate the trial.

Children with persistant neuropathic pain (DN4 (Diagnostic Neuropathic Pain) \> or = 3/7 ou DN4 \>or = 4/10) despite oral treatment following recommendations for neuropathic pain may be enrolled in the study.

For children not very painful (NRS-11 (Numeric Rating Scale) \< 7 and FDI (Functional Disability Inventory) \< 30) and without any oral treatment for neuropathic pain, the study may be proposed as first line treatment.

If both the child and his/her parents accept the trial, he/she will be included in the study.

It is a multicentric randomized controlled superiority trial in parallel arms :

* experimental arm: Capsaicin 8% cutaneous patch

* controlled arm : Hydrocolloid dressing

At M0, take place : baseline evaluation, agreement consent signature, inclusion and randomization, as well as first treatment application either capsaicin cutaneous patch or hydrocolloid dressing.

, If needed, the treatment may be done twice with a second application three months later (M3).

Tolerance is assessed during each application and by phone call in following days until stop of cold need.

Efficacy is assessed monthly by clinical consultation until the end of the study 4 months later (M4).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Children aged 12 to 17 years (lower age limit of 12 has been chosen to ensure NPSI full filling).

  • Male or female.

  • Persistent neuropathic pain more than 3 months after surgery or trauma despite treatment following recommendations.

  • Neuropathic pain is defined as a DN4 score equal to or greater than 3/7 or 4/10, and localized in a nerve territory explained by the surgery or the trauma.

  • Treatment, survey and follow up must be realized in an identified investigating center of the study

  • For patients of childbearing potential: use of an adequate method of contraception* during the course of the study through 48 hours after the last patch application (girls of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to the first patch application).

    • Adequate contraception includes sexual abstinence, progestogen-only oral hormonal contraception, where inhibition of ovulation is not the primary mode of action, male or female condom with or without spermicide, cap, diaphragm or sponge with spermicide, combination of male condom with either cap, diaphragm or sponge with spermicide (double barrier methods)
Exclusion Criteria
  • Intellectual deficiency not allowing full filling of NPSI.
  • Insufficient command of the French language to full fill NPSI and other evaluation tools.
  • Parents' refusal of consent.
  • Minor patients' opposition.
  • Underlying neurological disease.
  • Ongoing neurotoxic treatment.
  • Already treated by capsaicin.
  • Cutaneous lesion on pain area.
  • Patient presenting a pain area on the face, above the hairline of the scalp, and/or in proximity to mucous membranes
  • Hypersensitivity to the active substance or to any of the excipients listed in section 6.1 of Qutenza SmPC.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
QUTENZACapsaicin 8% patchThe experimental product is QUTENZA®, a cutaneous patch which contains 179 mg of capsaicin (capsaicin 8%).The patch measures 14 cm x 20 cm. The second application takes place three months after the first application.
PlaceboHydrocolloid dressingThe placebo comparator is a hydrocolloid dressing: COMFEEL PLUS TRANSPARENT, a medical device class IIb commercialized by Coloplast. The patch measures 15 cm x 15 cm. The second application takes place three months after the first application.
Primary Outcome Measures
NameTimeMethod
The change in Neuropathic Pain Symptom Inventory score (NPSI)At baseline (day of the patch application) and 4 months after patch application

The decrease in Neuropathic Pain Symptom Inventory score (NPSI) is evaluated before the first application (M0) of capsaicin or placebo and 4 months later (M4).

NPSI (Neuropathic Pain Syndrome Inventory) is a questionnaire without support, score from 0 to 100, higher score is worse outcome.

Secondary Outcome Measures
NameTimeMethod
Adverse event monitoringAt day 0, day 1, day 2, day 3 after patch application

Adverse event monitoring are collected during patch application and by phone calls in the following days.

Vital signsAt baseline, Month 1, Month 2, Month 3 and Month 4

Arterial pressure in mmHg

Dermal assessmentMonth 1, Month 2, Month 3 and Month 4

Dermal assessment is evaluated with questions concerning the feel of the treated area (YES/NO)

Treatment related pain and use of analgesic medicationAt baseline, day 1, day 2, Month 1, Month 2, Month 3 and Month 4

Intake of analgesic medication (YES/NO)

Duration of patch applicationDuring patch application : at baseline and at Month 3 if it is applicable

Duration of patch application in minutes

Neuropathic Pain Symptom Inventory score (NPSI)At baseline, Month 1, Month 2, Month 3 and Month 4

Global score and subscores of NPSI (Neuropathic Pain Syndrome Inventory) questionnaire without support, score from 0 to 100, higher score is worse outcome

Functional disability evaluation (FDI)At baseline, Month 1, Month 2, Month 3 and Month 4

Global score of FDI (Functional Disability Inventory) questionnaire, score from 0 to 60, higher score is worse outcome

Trial Locations

Locations (10)

CHU d'Amiens

🇫🇷

Amiens, France

CHU d&#39;Angers

🇫🇷

Angers, France

CHU de Bordeaux

🇫🇷

Bordeaux, France

CHU de Brest

🇫🇷

Brest, France

CHU de Nantes

🇫🇷

Brest, France

CHU de Lyon

🇫🇷

Lyon, France

CHU de Marseille

🇫🇷

Marseille, France

CHU de Montpellier

🇫🇷

Montpellier, France

CHU de Tours

🇫🇷

Tours, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

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