Capsaicin cream 0.025% as Monotherapy for Osteoarthritis: A double-blind study

The efficacy and safety of 0.025% capsaicin cream were evaluated when it was used as the only symptomatic therapy in patients with osteoarthritis (OA) pain. Patients (113) received either topical capsaicin or vehicle four times daily in this 12-week, double-blind, randomized, vehicle-controlled, multicenter study. Capsaicin was superior to vehicle in providing pain relief. At the end of the study, more patients on capsaicin (81 %) than vehicle (54%) were improved by physician's global evaluation (P = .03). Similar results were obtained by patient's global evaluation. Capsaicin-treated patients reported greater reduction of pain on the visual analog scale (VAS) at week 4 (P = .01), week 8 (P = .01), and week 12 (P = .02). Capsaicin -treated patients also had greater reduction in pain on passive range of motion by week 8 (P = .03) that was sustained through week 12 (P = .03). Joint tenderness evaluated by palpation declined in capsaicin-treated patients at week 4 (P = .03), week 8 (P = .01 ), and week 12 (P = .01 ). Adverse effects attributable to capsaicin were mild to moderate burning and stinging at the application site (46% of patients). The burning resolved in most patients; only 3 (7%) patients experienced burning at week 12. These results support the beneficial effects of 0.025% capsaicin cream as a first-line therapy for OA pain.