European Commission Approves New Pre-treatment Options for QUTENZA(TM) (8% Capsaicin Patch) in Peripheral Neuropathic Pain

Chertsey, England (ots/PRNewswire) -

- For Healthcare and Business Media -

Approval allows for more flexible approach to 8% capsaicin patch
treatment of peripheralneuropathic pain

The European Commission (EC) has approved expanded options for
pre-treatment prior to use of QUTENZA (8% capsaicin patch). Before
application the patient may now take an oral analgesic, or the
treatment area may be pre-treated with a topical anaesthetic.[1] The
8% capsaicin patch is the first and only licensed high concentration
(8%) capsaicin cutaneous patch for the treatment of peripheral
neuropathic pain in Europe.

The EC approval of the 8% capsaicin patch label amendment is valid
in all of the 27 European Union Member States plus Iceland,
Liechtenstein and Norway. The regulatory submission was supported by
data from the LIFT study, which aimed to investigate the use of an
oral analgesic as an alternative form of pre-treatment for the 8%
capsaicin patch.

In the LIFT study patients were randomised to either application
of lidocaine cream (a topical anaesthetic) or tramadol tablets (an
oral analgesic), prior to application of the 8% capsaicin
patch.[2],[3] All patients were then treated with the 8% capsaicin
patch for 60 minutes and followed up for 7 days to monitor pain
scores and tolerability. The primary endpoint of the LIFT study was
the proportion of subjects who tolerated 8% capsaicin patch treatment
which was defined as a patient using the patch for at least 90% of
the intended patch duration. The LIFT study was completed in April
2012 and the results will be presented at The 4th International
Congress on Neuropathic Pain (NeuPSIG) in May 2013.

Dr. Arun Bhaskar, Consultant in Pain Medicine, Anaesthesia &
Critical Care at The Christie NHS Foundation Trust in Manchester
says, "The 8% capsaicin patch has been a useful addition to the
management of difficult-to-treat neuropathic pain conditions like
post-herpetic neuralgia, HIV neuropathy and chemotherapy-induced
neuropathy. This label change will provide greater flexibility to
treating clinicians and should enable them to carry out treatment of
more patients per session, thus reducing the cost of treatment per
patient."

Anne Hodgkins, Senior Brand Director, Pain Management at Astellas
Pharma Europe Ltd commented, "Managing peripheral neuropathic pain is
challenging and the individual needs of the patient are paramount
when treatment decisions are made. We are committed to ensuring the
8% capsaicin patch is an accessible and convenient treatment option
for physicians and patients."

Conventional therapies for peripheral neuropathic pain can be
restricted by factors such as systemic side effects, drug-drug
interactions, slow onset of action, the need for titration and
multiple daily dosing.[4],[5],[6] The 8% capsaicin patch is designed
to act locally on the affected area and has not been associated with
the systemic side effects such as sedation and dizziness.[4],[5],[7]

Notes to editors

About Peripheral Neuropathic Pain

Peripheral neuropathic pain is caused by lesion or disease to the
peripheral somatosensory nervous system. Nerve damage that can lead
to peripheral neuropathic pain can happen as a result of a range of
different diseases, medications or traumatic injuries.

Exactly how many people suffer from neuropathic pain is not known
but estimates of the prevalence of neuropathic pain range from 3% to
as high as 8% according to a UK study.[8],[9] Estimates vary
considerably because of differences in the way neuropathic pain is
defined, the way in which the condition is assessed and the selection
of patients.[10]

It is a complex and difficult to treat disorder that can have a
detrimental effect on a patient's quality of life.[11],[12] Studies
suggest that, at present, only around a third of patients receiving
treatment for neuropathic pain achieve adequate pain relief.[13]

About the 8% capsaicin patch

8% capsaicin patch is approved by the European Commission for the
treatment of peripheral neuropathic pain in non-diabetic adults
either alone or in combination with other medicinal products for
pain. The 8% capsaicin patch is available in over 21 countries across
Europe.[7]

The efficacy and safety of the 8% capsaicin patch have been shown
in a broad range of neuropathic pain conditions, including
post-herpetic neuralgia and HIV-associated
neuropathy.[7],[14],[15],[16],[17] Phase-III clinical studies in
painful diabetic neuropathy and longterm safety studies are
ongoing.[7],[8]

Pain relief following application of the 8% capsaicin patch can
take up to two weeks to take full effect and can last for up to 12
weeks following a single application.[7] Significant reductions in
pain have been achieved with the 8% capsaicin patch when used alone
or in combination with other treatments for pain.[7] In addition to
providing pain relief, use of the 8% capsaicin patch has been shown
to reduce the use of concomitant medications and lead to improvements
in quality of life for patients.[20],[21],[22] The most commonly
reported side effects with the 8% capsaicin patch are transient and
self-limiting application site reactions such as pain and erythema
that tend to be mild to moderate in intensity.[7]

The treatment area may be pre-treated with a topical anaesthetic
or the patient might be administered an oral analgesic to reduce
potential application related discomfort. The 8% capsaicin patch is
applied to the area of pain and left in place for either 30 minutes
(when used on the feet) or 60 minutes (when used elsewhere on the
body).[7] Treatment can be repeated, if required, after 90 days. As a
result of treatment-related discomfort, transient increases in blood
pressure may occur during and shortly after treatment with the 8%
capsaicin patch.[7]

The patch delivers a high-dose of a synthetic form of capsaicin,
the substance found in chilli peppers, directly to the damaged pain
sensing nerves in the skin.[23] Applied to the area of pain, the high
concentration of capsaicin contained in the treatment is released
into the skin where it overstimulates the pain sensing nerves.
Overstimulating the pain sensing nerves makes them become
"defunctionalised", effectively reducing their spontaneous activity
and making them unresponsive to stimuli that normally cause pain for
patients with peripheral neuropathic pain.[24]

About Astellas Pharma Europe Ltd.

Astellas Pharma Europe Ltd., located in the UK, is the European
headquarters of Tokyo-based Astellas Pharma Inc. Astellas is a
pharmaceutical company dedicated to improving the health of people
around the world through the provision of innovative and reliable
pharmaceuticals. The organisation's focus is to deliver outstanding
R&D and marketing to continue growing in the world pharmaceutical
market. Astellas Pharma Europe Ltd. is responsible for 21 affiliate
offices located across Europe, the Middle East and Africa, an R&D
site and three manufacturing plants. The company employs
approximately 4,300 staff across these regions. For more information
about Astellas Pharma Europe, please visit http://www.astellas.eu.

QUT/12/0024/EU

March 2013

References

1. Astellas Data on File March 2013

2. EU Clinical Trials Register: http://www.clinicaltrialsregister.
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3. ClinicalTrials.gov:
http://www.clinicaltrials.gov/ct2/results?term=NCT01416116 Last
accessed: November 2012

4. Backonja M et al. NGX-4010, a high-concentration capsaicin
patch, for the treatment of postherpetic neuralgia: a randomised,
double-blind study. Lancet Neurol 2008;7(12 ):1106-12

5. Simpson DM et al. Controlled trial of high-concentration
capsaicin patch for treatment of painful HIV neuropathy. Neurology
2008;70(24):2305-13

6. O'Connor AB et al. Treatment of neuropathic pain: an overview
of recent guidelines. Am J Med 2009;122:S22-32

7. Qutenza (Capsaicin) EPAR. Available from:
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-
Product_Information/human/000909/WC500040453.pdf Last accessed: March
2013.

8. Gilron I et al. Neuropathic pain: a practical guide for the
clinician. CMAJ 2006;175(3):265-75

9. Mailis Gagnon A et al. Systematic review of the prevalence of
neuropathic pain. Eur J Pain 2007;11 (Suppl. 1):S202-S203 [Abstract
No. 457]

10. National Institute for Health and Clinical Excellence (NICE)
Neuropathic Pain: The pharmacological management of neuropathic pain
in adults in non-specialist settings. March 2010. Available from:
http://www.nice.org.uk/nicemedia/live/12948/47949/47949.pdf Last
accessed: November 2012

11. Gálvez R et al. Cross-sectional evaluation of patient
functioning and health-related quality of life in patient with
neuropathic pain under standard care conditions. Eur J of Pain
2007;3:244-55

12. Smith B et al. Health and quality of life associated with
chronic pain of predominantly neuropathic origin in the community.
Clin J Pain 2007;23:143-9

13. Jensen T et al. Pharmacology and treatment of neuropathic
pains. Current Opinion in Neurology 2009;22:467-474

14. Hansson P et al. A Swedish prospective observational
multicenter study to evaluate efficacy and safety in patients with
peripheral neuropathic pain receiving their first Qutenza(TM)
treatment." Presented at World Congress on Pain, Milan, August 2012
[Abstract PT 422]

15. Klimes J et al. High concentration (8%) of capsaicin patch:
Effectiveness in real clinical practice for treatment of neuropathic
pain of non-diabetic etiology in the Czech Republic. Presented at
World Congress on Pain, Milan, August 2012 [Abstract PH 107]

16 . Bhaskar A et al. Chemotherapy-induced painful neuropathy:
treatment with the capsaicin 8% patch. Presented at European
Association for Palliative Care, Norway, June 7 - 9, 2012 [Poster
466]

17. Bhaskar A et al. Management of neuropathic pain (NP) using the
capsaicin 8% patch in patients with cancer. . Presented at European
Association for Palliative Care, Norway, June 7 - 9, 2012 [Poster
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18. EU Clinical Trials Register: https://www.clinicaltrialsregiste
r.eu/ctr-search/search?query=E05-CL-3002 Full Download. Last
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19. ClinicalTrials.gov:
http://www.clinicaltrials.gov/ct2/results?term=NCT01478607 Last
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20. Wagner T, Roth-Daniek A, Poole C. Reduction In Concomitant
Neuropathic Pain (Np) Medication Use After Treatment With The
Capsaicin 8% Patch: A Retrospective Analysis. 7th Congress of the
European Federation of IASP Chapters (EFIC), September 21-24, 2011.
Abstract 469

21. Dolezal T et al. High concentration capsaicin patch improves
quality of life in patients with neuropathic non-diabetic pain.
Presented at World Congress on Pain, Milan, August 2012 [Abstract PH
124]

22. Vocelka M et al. Lower consumption of concomitant pain
medication and other resource use after administration of 8%
capsaicin patch: Results of the observational study. Presented at
World Congress on Pain, Milan, August 2012 [Abstract PH 135]

23. Knotkova H et al. Capsaicin (TRPV1 agonist) therapy for pain
relief: Farewell or revival? Clin J Pain 2008;24(2):142- 154

24. Anand P et al. Topical capsacin for pain management:
therapeutic potential and mechanisms of action of the new
high-concentration capsaicin 8%

ots Originaltext: Astellas Pharma Europe Limited
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