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

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

  PR Newswire

  CHERTSEY, England, March 14, 2013

CHERTSEY, England, March 14, 2013 /PRNewswire/ --

- For Healthcare and Business Media -

Approval allows for more flexible approach to 8% capsaicin patch treatment of
peripheral  neuropathic 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.eu/ctr-search/search?query=2010-023258-34
Full Download. Last accessed: November 2012

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.pdfLast 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™ 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 465]

18. EU Clinical Trials Register:
https://www.clinicaltrialsregister.eu/ctr-search/search?query=E05-CL-3002
Full Download. Last accessed: November 2012

19. ClinicalTrials.gov:
http://www.clinicaltrials.gov/ct2/results?term=NCT01478607 Last accessed:
November 2012

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%

Contact: Contacts for enquiry or additional information: Astellas Pharma
Europe Ltd.: Mindy Dooa, Tel: +44-(0)203-379-8035 / +44-(0)7826-912-339,
mindy.dooa@astellas.com; Pegasus: Sylva Michelli, Tel: +44-(0)1903-836745 /
+44-(0)7507-598-427, smichelli@pegasuspr.co.uk