Monday, January 23, 2012

What is Capsaicin in intranasal application?

What is Capsaicin in intranasal application?

Capsaicin is a phenolic chemical contained within the oil of the Capsicum pepper.

Capsaicin has been used clinically with moderate success as a topical treatment for pain from rheumatoid and osteoarthritis, psoriasis, diabetic neuropathy, and postherpetic neuralgia.



When used intranasally, capsaicin irritates the nasonasal area. However, the area becomes desensitized to the irritation after repeated use. Nerve endings responsible for rhinorrhea, sneezing, and congestion become desensitized when capsaicin is applied to the nasal mucosa. Capsaicin use has been targeted at patients presenting congestion, rhinorrhea, sneezing, or a combination of these symptoms.

Clinical studies revealed a 60% reduction in nasal airway resistance. In most patients, effectiveness continued for more than 4 months after study completion. In addition, most patients showed significantly improved scores on visual analog scales. However, no significant difference was documented for nasal blockage, rhinorrhea, sneezing, coughing, mucus production, or eye irritation before, during, or after study completion. Documented adverse reactions were limited to initial nasal irritation and increased nasal airway resistance.

The majority of studies on capsaicin intranasal application have been addressed to nasal mucosa pathologies (idiopathic rhinitis, allergic rhinitis, chronic rhinopathy, etc.).

A double-blind, randomized, placebo-controlled pilot study on capsaicin nasal spray was recently completed (pending publication). The study was designed to evaluate the effectiveness and safety of capsaicin for the treatment of sinus and nasal congestion in patients suffering from non-allergic rhinitis. It measured the improvement in nasal congestion, sinus pressure, and pain. It also evaluated speed of action and safety parameters. Key findings include:
  • Capsaicin started to provide relief from sinus/nasal congestion, pressure, and headache pain in less than one minute.
  • Capsaicin subjects continued to show a statistically significant improvement in nasal congestion and sinus pain at each of the established intervals and follow-up visits over the two-week duration of the study.
  • Capsaicin is a powerful solution for sinus congestion, pressure and headaches that not only provides immediate relief, but also sustains this relief throughout the course of the two-week treatment period.
  • Additional clinical trials are needed to confirm these findings in a larger patient population.

Capsaicin versus Nasodren /Sinuforte

Articles comparing the efficacy of Nasodren/Sinuforte versus capsaicin have not been published. According to available data, we have compiled the following table comparing both products:

 

Nasodren/Sinuforte

Capsaicin

Clinical trials in rhinosinusitis

15

1

Reduction of mucosal obstruction and mucopurulent secretion evaluated by endoscopy

Shown

Not Shown

Reduction of sinus occlusion evaluated by CT-Scan.

Shown

Not Shown

Provides significant therapeutic benefit in adults and children (aged ≥5 years) with acute and chronic rhinosinusitis as a first line, administered in monotherapy or in combination

Shown

Not Shown

 

 

Administered with other drugs efficacy is improved, especially with antibiotics, antibiotics + corticoids and decongestants

Shown

Not Shown

 

 

Is associated with lower costs per successfully treated patient, in terms of the health system and from a socio-economic perspective*

Shown

Not shown

* Pending publication

 

 

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