8% capsaicin patches for HIV-induced polyneuropathy: a systematic review and meta-analysis

BACKGROUND: Human immunodeficiency virus is a harrowing illness that causes significant sequelae besides immune suppression. One of the long-term effects of both virus and antiviral medication is distal sensory polyneuropathy. Treating this HIV-induced neuropathy is a difficult challenge for clinicians, with standard of care medications having significant side effects. Recently, 8% topical capsaicin patches have been shown to help with various other forms of neuropathy, but no systematic review has investigated the potential benefit of HIV-induced neuropathy. METHODS: ), followed by a random-effects meta-analytics based on the moderately high degree of heterogeneity. RESULTS: Our investigation found a total of seven articles that fit our inclusion and exclusion criteria. The overall effect size for the most common patch-application duration was d = 0.991 (95%CI: 0.619-1.36) for improvement in pain score. To control for our high heterogeneity, a leave-out analysis was conducted on the studies with highest risk of bias, with repeat meta-analytics denoting a d = 0.96. CONCLUSION: Our systematic review and meta-analysis notes that topical 8% lidocaine patches are effective in reducing neuropathic pain in patients with HIV-neuropathy. Future larger studies should be conducted to investigate the place of 8% capsaicin patches in the treatment algorithm for HIV-neuropathy. PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier CRD420251114796.