--most of us have learned to look critically at studies/papers that come out trumpeting "magnificent" results, especially those published int he US, as opposed to those that come from Canada, Europe, or Japan, places in which the influence of big pharma on what gets published and what doesn't isn't as pervasive.

Still, many of us would like to have new drugs that show promise for the relief of neuropathic (and other) pain. Substances based on capsaicin are certainly worth investigating, and it is likely they will have positive effects for at least some people, though these may be variable based on dose, formulation, and particular genetic background. In that sense, they'll be very much like other drugs used for neuropathic pain--anti-epileptics, anitdepressants, and even opiates and synthetic equivalents (such as Tramadol) work well for some and not others.

In all probability, individual differences in genetic make-up, substance metabolism, and pain mechanism explain the highly variable results associated with these trials, though many of these are still too complex to disentangle. The problem comes when studies that show equivocal results on symptoms, or other effects not intended, are either suppressed or relegated to less widely disseminated media channels.