Topical analgesics can reduce opioid use

Chronic, noncancer pain, among which neuropathic pain affects around 200 million people in Europe and the USA and is one of the most frequent reasons for patients to visit their primary care physician. Patients experiencing chronic pain often also have multiple other disorders and take many drugs. Unfortunately, most analgesics, such as antiepileptics, antidepressants, opioids and NSAIDs, are associated with adverse events and drug-drug interactions and tolerability issues reduce compliance and efficacy. Topical and transdermal analgesic formulations have many advantages for patients, especially for the elderly, and combine efficacy with absent or low systemic levels of drug.

The Optimizing Patient Experience and Response to Topical Analgesics (OPERA) study is an observational survey study of patients who experience chronic neuropathic or other pain and who have been prescribed a topical or transdermal analgesic formulation in various combinations, such as based on diclofenac, ketoprofen, amitriptyline, gabapentin, bupivacaine or other pain-relieving transdermal cream.

A total of more than 400 patients had been prescribed some form of topical analgesic formulation, including:

  • Flurbiprofen (20%)
  • Amitriptyline (5%)
  • Magnesium Chloride (10%)
  • Gabapentin (6%)
  • Bupivicaine (2%)


The Overall Brief Pain Inventory (BPI) scores showed major improvements, where overall severity scores decreased significantly by 31.3% (P< 0.001). Specifically, all 4 components of the BPI Severity score showed clear improvements.

Especially important was the fact that topical analgesics can reduce the intake of painkillers such as opioids and NSAIDs.

Topical Innovations is dedicated to find more topical analgesic formulations to improve quality of life of pain patients and reduce pain in neuropathic pain states.


Gudin J, Brennan M, Harris E, et al. Decreased pain following use of a topical analgesic: Interim results from the Optimizing Patient Experience and Response to Topical Analgesics (OPERA) observational study. Poster presentation at: 8th Annual Meeting of the World Institute of Pain; May 20-23, 2016; New York, NY.