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QUTENZA works differently to target painful diabetic peripheral neuropathy (PDPN) of the feet

QUTENZA reversibly quiets and depletes the TRPV1-expressing nociceptive nerve fibers1

The active ingredient in QUTENZA is capsaicin, a highly selective agonist for the transient receptor potential vanilloid 1 receptor (TRPV1) found on nociceptive nerve fibers in the skin.

Topical administration of capsaicin causes an initial enhanced stimulation of the TRPV1-expressing cutaneous nociceptive fibers that may be associated with painful sensations.
Prolonged exposure to capsaicin subsequently desensitizes TRPV1, hence reducing its responsiveness to painful stimuli.

Additionally, exposure to high concentrations of capsaicin in the skin, mainly the epidermis, initiates a (reversible) reduction of TRPV1-expressing nociceptive nerve fibers. This is driven by multiple mechanisms associated with a marked increase of intracellular calcium.

Over the course of several months, there may be a gradual re-emergence of painful neuropathy, thought to be due to the reinnervation of TRPV1-expressing nerve fibers in the treated area.