PS2.188Topical capsaicin for pain in osteoarthritis – an evidence based review

Vânia  Patrícia Oliveira Guedes(1), JP Castro(2), I Brito(3)
(1) Family Health Care Unit Faria Guimarães, General practice, Oporto, Portugal
(2) Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
(3) Centro Hospitalar de São João, Rheumatology, Oporto, Portugal
Corresponding author: Dr Vânia  Patrícia Oliveira Guedes, USF Faria Guimarães, Porto, Portugal.
Background & Aim: Osteoarthritis (OA) is the most common joint disorder worldwide and a significant cause of disability. The predominant symptom, pain, is most often treated with acetaminophen or oral non-steroidal anti-inflammatory drugs, although they are associated with a significant risk of side effects. Topical capsaicin may represent an effective and safe alternative in some patients. The aim of this review is to examine the evidence for the efficacy of topical capsaicin in the management of pain caused by OA.
Method: Databases were searched for guidelines, meta-analysis, systematic reviews and randomized controlled trials, published between January 2004 and January 2016, in Portuguese, English or Spanish, using the search terms “capsaicin” and “osteoarthritis”. To evaluate the level of evidence and the strength of recommendation, the Strength of Recommendation Taxonomy (SORT) of the American Academy of Family Physicians was used.
Results: We found 120 articles, of which 6 (3 systematic reviews and 3 guidelines) fulfilled the inclusion criteria. These studies support the benefits of topical capsaicin in reducing pain from OA, as compared to placebo. They demonstrate its safety profile with few adverse effects.
Conclusions: Available evidence of the analgesic efficacy of topical capsaicin in osteoarthritis recommends its use. However, the studies have some limitations, like the short duration of randomized controlled trials, the difficulty of treatment blinding and samples of reduced size, so further studies are needed in this area. It is attributed to the review the strength of recommendation B.