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      Liposomal topical capsaicin in post-herpetic neuralgia: a safety pilot study Translated title: Capsaicina lipossomal tópica na neuralgia pós-herpética: um estudo piloto de segurança

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          Abstract

          Topical treatments have gained popularity for general use as an adjunct to systemic drugs in neuropathic pain, but their use produces variable clinical results and local adverse events. Objective To evaluate the safety and analgesic effect of a formulation of liposomal capsaicin (LC) (0.025%) in patients with post herpetic neuralgia (PHN). Method Patients who remained symptomatic after first-and second-line treatment were randomized to receive LC for six weeks in a placebo-controlled, crossover design study. Clinical assessment was performed at baseline, in the second, fourth and sixth week of treatment. Results Thirteen patients completed both treatment periods. Visual Analog Scale (VAS) was significantly decreased after the end of the study (p = 0.008), however the effect of treatment was not significant (p = 0.076). There was no difference on global impression of change and other pain characteristics. LC was safe and well tolerated. However, at the concentration used, its analgesic effects were marginal and not significant.

          Translated abstract

          Os tratamentos tópicos ganharam popularidade para uso geral como um adjuvante de medicamentos sistêmicos na dor neuropática, mas seu uso produz resultados clínicos variáveis e eventos adversos locais. Objetivo Avaliar o efeito de segurança e analgesia de uma formulação de capsaicina lipossomal (LC) (0,025%) em pacientes com neuralgia pós-herpética. Método Os pacientes que permaneceram sintomáticos após tratamento de primeira e de segunda linha foram randomizados para receber LC durante seis semanas em um estudo cruzado controlado por placebo. A avaliação clínica foi realizada no início do estudo, na segunda, quarta e sexta semana de tratamento. Resultados Treze pacientes completaram dois períodos de tratamento. Escala Visual Analógica diminuiu significativamente após o final do estudo (p = 0,008), no entanto, o efeito do tratamento não era significativo (p = 0,076). Não houve diferença na impressão global de mudança e de outras características da dor. LC foi segura e bem tolerada. No entanto, para a concentração utilizada, os seus efeitos analgésicos foram marginais e não significativos.

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          The use of lipid-based nanocarriers for targeted pain therapies

          Sustained delivery of analgesic agents at target sites remains a critical issue for effective pain management. The use of nanocarriers has been reported to facilitate effective delivery of these agents to target sites while minimizing systemic toxicity. These include the use of biodegradable liposomal or polymeric carriers. Of these, liposomes present as an attractive delivery system due to their flexible physicochemical properties which allow easy manipulation in order to address different delivery considerations. Their favorable toxicity profiles and ease of large scale production also make their clinical use feasible. In this review, we will discuss the concept of using liposomes as a drug delivery carrier, their in vitro characteristics as well as in vivo behavior. Current advances in the targeted liposomal delivery of analgesic agents and their impacts on the field of pain management will be presented.
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            A new approach for the evaluation of niosomes as effective transdermal drug delivery systems

            The central motivation for this study was to evaluate if the increased hydrophilic drug permeation across the skin, which is always observed in presence of vesicular systems, is dependent on the structural organization of niosomes, that are used to transport the active molecules, or if it is only dependent on the surfactant dual nature. To answer this question, non-ionic surfactants belonging to the class of Pluronic and sucrose esters were used both as components of niosomal systems or in the form of sub-micellar solutions. The obtained niosomes were characterized by their entrapment efficiency, size and morphology. The enhancing effect of niosomes on the ex vivo percutaneous penetration of a model drug was investigated using a Franz-type diffusion chamber and compared to that obtained by using sub-micellar solution of surfactant or achieving pretreatment of the skin with surfactants' sub-micellar solution or empty niosomes. The results suggest that the surfactants used in this study could be considered as percutaneous permeation enhancers only when they are in the form of drug-loaded vesicular systems: no percutaneous promotion was achieved by using sub-micellar solution containing free Sulfadiazine sodium salt or performing pretreatment with empty niosomes or sub-micellar solutions of the surfactant. In our experiments, only niosomes act as effective transdermal drug delivery systems.
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              Niosomes vs microemulsions: new carriers for topical delivery of Capsaicin.

              The development of advanced biomaterials and drug-delivery systems has had a significant impact on our ability to treat several diseases. A new study was performed on niosomal formulations obtained from a mixture of commercial surfactants (Tween 80 and Span 80) to be applied topically for the release of Capsaicin. Capsaicin is the pungent principle of red pepper and it has a variety of pharmacological actions on the cardiovascular, respiratory and nervous systems. Niosomal carriers were prepared using a particular ratio between surfactants, to obtain systems with a specific HLB (10,12,14) and characterized in terms of dimension, morphology and their drug entrapment efficiency. Niosomes were compared to microemulsions prepared from the same surfactants in the same ratio, to evaluate their possible use in transdermal drug delivery. As regards the in vitro percutaneous permeation of Capsaicin from both microemulsions and niosomal formulations, it was carried out using diffusion Franz cells. The results indicate that niosomes could better promote the transdermal delivery of Capsaicin, with respect to microemulsions, even if both carriers could be an effective vehicle for topical delivery of this drug. Copyright © 2011 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                March 2015
                : 73
                : 3
                : 237-240
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Instituto do Câncer de São Paulo Octavio Frias de Oliveira Brazil
                [3 ] Universidade de São Paulo Brazil
                Article
                S0004-282X2015000300237
                10.1590/0004-282X20140232
                698350a3-78ea-4473-a310-358ac96a3ae4

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                capsaicin,pain,neuralgia,analgesia,rash,adverse events,capsaicina,dor,neuralgia, analgesia,efeitos adversos

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