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Compliance Problems, Placebo Effect Cloud Trials of Topical Analgesic

Paul Cotton
JAMA. 1990;264(1):13-14. doi:10.1001/jama.1990.03450010013002.
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THE ACTIVE AGENT in hot peppers is getting bland reviews from most clinicians who try it as topical treatment for peripheral neuropathies.

Basic scientists, meanwhile, say the mechanism of action of capsaicin makes it a tantalizing research tool. (Please see accompanying article.)

Results of a double-blind, placebo-controlled, 8-week trial in 277 patients with diabetic neuropathy indicate 0.075% topical capsaicin ointment (Axsain, Galen-Pharma, Northbrook, Ill) is effective, says Rup Tandan, MD.

Much skepticism greeted his results at the American Academy of Neurology meeting in Miami Beach. But he says those ready to give up on capsaicin are not making sure patients use it right.

Tandan, assistant professor of neurology at the University of Vermont College of Medicine, Burlington, says pain relief was reported by 75% of patients who received this treatment vs 45% of those who received a placebo. But the benefit became statistically significant only after 4 weeks, when several


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