The All Wales Medicines Strategy Group (AWMSG) has recommended Astellas Pharma's Qutenza (capsaicin) 8% patch as a treatment option for difficult-to-treat nerve pain.

The Qutenza patch has received a recommendation from the AWMSG for use as an option for the treatment of peripheral neuropathic pain (PNP) in non-diabetic adults, in combination with other medicinal products for pain and in patients who have not received adequate benefit from, or are intolerant to, alternative conventional treatments. It is not recommended for use alone for the treatment of PNP in non-diabetic adults.

PNP is caused by damage to pain-sensing nerves, which can happen as a result of a range of different diseases, medications or traumatic injuries. The Qutenza patch uses a synthetic form of capsaicin, the substance found in chilli peppers which gives them their "heat," to change the way these pain-sensing nerves work in the area of skin affected. The patch can provide at least 12 weeks' pain relief following a single 30- or 60-minute application.

Exactly how many people suffer from neuropathic pain is not known but estimates for the percentage of the population affected are typically in the 1%-2% range - although some sources estimate prevalence to be as high as 8%. PNP is a complex and difficult-to-treat disorder that can have a detrimental effect on quality of life, and studies suggest that, at present, only around a third of patients receiving treatment for neuropathic pain achieve adequate pain relief, says the company.

Neuropathic pain can be difficult to explain - "most people affected describe feelings such as pins and needles, stabbing sensation, burning sensation or sometimes sharp shooting pain like an electric shock," notes Dr Arun Bhaskar, consultant in pain medicine, anaesthesia and critical care at The Christie NHS Foundation Trust.

"Many conventional treatments are limited by factors such as side effects and drug-drug interactions, which has led to an interest in localised treatments for PNP. A single treatment with the capsaicin patch can give people suffering with PNP relief for at least 12 weeks, and gives doctors an effective and well-tolerated treatment option for this challenging condition," said Dr Bhaskar.

- In February 2011, the Scottish Medicines Consortium (SMC) recommended the Qutenza patch for restricted use within NHS Scotland in patients with post-herpetic neuralgia (PHN) who have not achieved adequate pain relief from, or who have not tolerated, conventional first- and second-line treatments. The patch has not been reviewed by the National Institute for Health and Clinical Excellence (NICE).