Lidocaine Medicated Plaster Effective, Well-Tolerated for Localized Neuropathic Pain

A 700 mg lidocaine medicated plaster (LMP) was found to be an effective treatment for localized peripheral neuropathic pain (l-PNP), according to study results published in Pain Management.

Patients included in the German Pain eRegistry (GPeR) with l-PNP, who used LMP (n=3081) between 2018 and 2019, were matched with those using recommended oral first-line therapies (n=3081). Pain intensity on a 100 mm-point visual analog scale, pain intensity index, patient-reported outcomes, and safety were assessed.

The LMP and oral medication cohorts were 64% and 64% women; had a mean age of 60.7±14.5 and 60.8±14.6 years; BMI was 25±6.2 and 25.1±6.6; 64.3% and 65.5% had pain for over 1 year; and 96.3% and 96.5% had comorbidities, respectively. In each cohort, patients were receiving treatment for postherpetic neuralgia (n=1711), diabetic polyneuropathy (n=732), postsurgical neuropathy (n=531), and other indications (n=107).

The oral medication cohort received antiepileptic drugs (36%), selective serotonin-norepinephrine reuptake inhibitors (32.8%), or tricyclic antidepressants (31.2%).

Recipients of the oral medications received treatment for fewer days (mean, 102±66.6) compared with the LMP cohort (mean, 144.2±47.2), and oral medication dosing was higher (percentage of maximum recommended dose, 71.9% vs 50.5%; P <.001). More of the oral medication recipients discontinued treatment at less than or equal to 24 weeks (54.9%) compared with the LMP group (27.3%).

All study participants were using concomitant analgesic therapy at baseline. At 6 months, more of the LMP cohort had discontinued use of concomitant therapy (43.1% vs 10.5%; P <.001).

The change in pain intensity for an average day was -30.49 mm for the LMP and -17.39 mm for the oral medication cohorts. The difference between groups was -13.10 (95% CI, -13.99 to -12.21; P <.001) mm, confirming noninferiority.

At weeks 4, 12, and 24, significantly more LMP recipients reported a reduction of greater than or equal to 30% or greater than or equal to 50% in average pain intensity compared with oral medications (all P <.001). In addition, patients using LMP reported more improvements to disability, quality of life impairment, physical and mental quality of life, and clinical pain phenotype (all P <.001).

Drug-related adverse events were reported by 9.4% and 58.8% (P <.001) of the LMP and oral medication recipients, respectively. The most common events among the LMP group were application site reactions and other skin-related reactions. For oral medications, patients reported nervous system, psychiatric, and gastrointestinal disorders.

This study may have been biased by not having access to information about treatment compliance.

The study authors concluded that real-world data confirmed the efficacy and tolerability of a 700 mg LMP for the treatment of l-PNP, indicating it may be a viable treatment option for the patients who discontinue recommended oral medications due to adverse events.

“LMP treatment provided significantly better pain relief and greater improvements in daily functioning and quality of life than [oral medications],” the study authors wrote.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Überall MA, Bösl I, Hollanders E, Sabatschus I, Eerdekens M. Localized peripheral neuropathic pain: topical treatment with lidocaine 700 mg medicated plaster in routine clinical practice. Pain Manag. Published online January 10, 2022. doi:10.2217/pmt-2021-0117

This article originally appeared on Clinical Pain Advisor