Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebo-controlled study

Details

Serval ID
serval:BIB_B66EFC93E03A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebo-controlled study
Journal
Pain
Author(s)
Meier  T., Wasner  G., Faust  M., Kuntzer  T., Ochsner  F., Hueppe  M., Bogousslavsky  J., Baron  R.
ISSN
0304-3959 (Print)
Publication state
Published
Issued date
11/2003
Peer-reviewed
Oui
Volume
106
Number
1-2
Pages
151-8
Notes
Clinical Trial Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't --- Old month value: Nov
Abstract
Peripheral neuropathic pain syndromes (PNPS) are difficult to treat because commonly used analgesics are often ineffective when, for example, touch-evoked allodynia, hyperalgesia, and pain paroxysms are present. To investigate whether lidocaine patch 5% treatment is also effective in postherpetic neuropathy (PHN) and in other PNPS, 40 patients with various forms and localizations of PNPS completed a prospective, randomized, placebo-controlled, two-way, cross-over study in three medical hospitals. Patients suffering from pain in a localized skin area with intensity above 40 mm visual analog scale (VAS) and a stable consumption of pain medication were included in this study. The study was divided into four phases: 3-day run-in phase, treatment phase 1, wash-out period, and treatment phase 2, each lasting 1 week. At the discretion of the patients, up to four patches (covering a maximum of 560 cm2) were applied onto the maximally painful area for 12 consecutive hours daily, always either by day or at night. Throughout the four phases, ongoing pain, allodynia, quality of neuropathic symptoms, quality of sleep, and adverse events were assessed. When, after the wash-out period, the pain intensity scores did not return to the pre-treatment values (+/-20%), these patients were excluded from the study. The present study revealed that, as an add-on therapy, the lidocaine patch 5% was clearly effective in reducing ongoing pain (P=0.017) and allodynia (P=0.023) during the first 8 h after application and that the patches also worked well over a period of 7 days (P=0.018) in diverse focal PNPS. Calculation of the numbers needed to treat (NNT) to obtain one patient with more than 50% relief of ongoing pain revealed that the NNT of 4.4 in the present study compared reasonably well with other studies of PHN, such as topically applied capsaicin (NNT: 5.3-infinity) or systemic treatment with gabapentin (NNT: 3.2-5.0).
Keywords
Administration, Topical Aged Anesthetics, Local/*administration & dosage/adverse effects Cross-Over Studies Double-Blind Method Female Humans Lidocaine/*administration & dosage/adverse effects Male Middle Aged Pain/*drug therapy/etiology Peripheral Nervous System Diseases/complications Placebos Prospective Studies Sleep Treatment Outcome
Pubmed
Web of science
Create date
25/01/2008 12:44
Last modification date
20/08/2019 15:24
Usage data