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 April/May 2015
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Efficacy and Safety of Qutenzatm (8% Capsaicin Patch)


Neuropathy is one of the most common long-term complications of diabetes mellitus (DM) and painful neuropathy can be challenging to treat. There is no consensus on optimal treatment and many current therapies are limited by their tolerability, the need for titration, drug-drug interactions, administration of multiple daily doses, or the invasive nature of surgical procedures (Spruce et al., 2003; Baron & Wasner 2006). QutenzaTM, an 8% capsaicin dermal patch, has demonstrated analgesic efficacy in post-herpetic neuralgia and painful HIV-associated neuropathy. This study assessed its efficacy and safety in patients with Painful Diabetic Peripheral Neuropathy (PDPN) in a phase III trial.


Previous clinical studies of Qutenza in other painful aetiologies (post-herpetic neuralgia and HIV-associated neuropathy) have shown a significant effect of Qutenza at 2 weeks and for this reason pain status was assessed over the period 2-8 weeks and 2-12 weeks. While both assessments showed statistically significant effects for Qutenza, there was a slightly longer lag period before the analgesic effect of Qutenza became evident in PDPN (around 3-4 weeks) than in the other aetiologies (1-2 weeks) and thus the data for the latter period showed a higher level of statistical significance.


Qutenza treatment resulted in statistically significant improvements over placebo in reducing the daily pain score from baseline to weeks 2-8 in PDPN and extend the range of neuropathic pain aetiologies (PHN and HIV-AN) for which the efficacy of Qutenza has been demonstrated. Consistent with the results of previous controlled clinical trials of Qutenza, adverse reactions were predominantly limited to application site reactions.


Source:  Authors: Stoker, M.,1 Jacobs, H.,1 Lloyd, A.,1 Long, S.K.,1 Simpson, D.M2 - 1. Astellas Pharma Global Development-Europe, Sylviusweg 62, PO Box 344, 2300 AH Leiden, The Netherlands. 2. Professor of Neurology, Director, Clinical Neurophysiology Laboratories, Director, Neuromuscular Division, Director, Neuro-AIDS Program, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai.

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Ezy Tai Chi: A Simpler Practice for Seniors

   As a form of exercise, tai chi increasingly appeals to the growing proportion of older adults that looks for alternative and convenient ways to exercise for health.  Originally developed for martial arts purposes in C hina more than 300 hundred years ago, this practice has been used as a traditional exercise to improve fitness, health and longevity for individuals of all ages. Tai chi's low-to-moderate intensity and beneficial effects on strength, flexibility, breathing and balance make it especially attractive to mature adults.


Basically, tai chi is a series of individual movements, or forms, linked together to flow smoothly from one to another.  In addition to the physical movement and meditational features of its practice, tai chi is intended to cultivate qi (pronounced chee), an internal force or vital energy-the nature of which is not fully understood. These energy pathways connect organs, joints and muscle groups.



Yin (inactivity) and yang (activity) are opposite, but complementary, forces of nature that need to be in balance for sustaining health and emotional healing (e.g. static/moving, active/passive, tension/relaxation, or forceful/yielding). Shifting body weight creates a continuous reciprocity of yin and yang states in tai chi.  


 Simplified tai chi

Several styles of tai chi exist, some historic/traditional and some of more recent origin.  Ezy Tai Chi created, by scientists from Oregon Research Institute in Eugene, Oregon, reduces the number and complexity of the 24-form yang style of tai chi to just eight forms and therefore is well suited to the physical and mental needs of older adults. Although preferably done while standing, Ezy Tai Chi can also be performed in a chair by participants who have a problem with standing or who depend on ambulatory supports (i.e. walker, cane or wheelchair). When performed in a seated position, these movements work the full range of motion for the arms, shoulders and torso.  The Ezy Tai Chi sequence can take less than three minutes to complete, depending on an individual's mobility level.


Ezy Tai Chi: health benefits


Ezy Tai Chi provides training likely to improve muscle strength through static and moving exercises, while addressing the need to control balance over a dynamically changing base of support. This practice also improves balance by involving interlimb coordination and coordination between lower-extremity and upper-body movements. In addition, the training may increase the balance response repertoires older adults can use in balance-challenging situations.


 Specific program benefits

Ezy Tai Chi is suitable as a home-based activity for older adults or as a programming option for those health and wellness organizations that serve the mature market.  Ezy Tai Chi allows older people to experience success and move toward achieving mastery in their own living environment. Home practice also removes the transportation/travel barrier of coming to a class and allows participants to work on routines in their own time, which potentially increases exercise adherence. But older adults should first take a class from a suitably qualified and experienced instructor, so they are introduced to the initial modeling and understanding of the pace, flow and transitions between movements.


To read the full article and watch an Instructional Video click here. 

Source: K. John Fisher, Ph.D.; Fuzhong Li, Ph.D.; and Machiko Shirai, M.S., The Journal on Active Aging, May June 2004

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Disclaimer: The information contained in this newsletter is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a qualified health care provider. You are strongly encouraged to consult a neurologist with any questions or comments you may have regarding your condition. The best care can only be given by a qualified provider who knows you personally.


Save the Date:

Facebook Chat 

Wednesday, May 20th at 7pm CST


Please join us as The Foundation for Peripheral Neuropathy partners with PainPathways Magazine for a FB Chat with Dr. Shanna K. Patterson on "How to Live Well with Neuropathy."


Dr. Patterson is currently the director of Electromyography (EMG) at Mount Sinai Roosevelt Hospital, and an assistant professor of Neurology at the Icahn School of Medicine at Mt. Sinai in New York City. Dr. Patterson will be responding to YOUR questions live via FB! 


For more information click here!