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A new groundbreaking medication that offers pain relief for moderate to severe pain in adults without the risk of addiction was recently approved by the Food and Drug Administration.
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Suzetrigine, marketed as Journavx™, is part of a new class of drugs called Nav1.8 inhibitors. These drugs block specific sodium channels. Studies show that it is as effective as hydrocodone or Vicodin when treating acute pain.
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A pain management specialist from Swedish shares the remarkable story of this innovative drug and explains how it could change the way pain is managed in the future.
A new drug could change the way we manage pain
A new form of pain medication that decreases pain impulses before they reach your brain recently earned approval from the U.S. Food and Drug Administration. And — unlike opioid pain medications— this groundbreaking new medication is not addictive.
Suzetrigine, made by Vertex Pharmaceuticals and sold as Journavx™, is a new type of pain management medication that works by inhibiting or reducing pain signals from reaching your brain. Research shows it’s as effective as opioid-based Vicodin for relieving moderate to severe acute pain in adults without the potential for addiction. And that could be a game changer for people in pain.
“In studies, Suzetrigine was equally as effective as hydrocodone in two postoperative pain studies. That’s significant because if this class of medicine could be as effective as opioids without the chance of developing dependence or addiction, it could be a powerful alternative and option for patients,” says Steven Stanos, D.O., pain medicine specialist at Swedish. “The sensation of pain involves a complex array of neurochemical and receptor changes in the body. A significant part of pain signaling involves conduction of electrical activity generated across nerves, many times via sodium channels. Medications designed to block or limit any one of these pathways, including nerve conduction, could be a valuable tool or option in our toolbox of medications for patients. ”
We talked to Dr. Stanos to learn more about this drug and its innovative relief method. Here’s what he shared.
In a class all its own
When you’re injured, your body sends nerve impulses from special receptors in the tissue letting your brain know something hurts. These electrical impulses travel along specific sodium channels on nerves to the spinal cord and then to the brain. When they reach your brain, you feel pain.
Suzetrigine is the first drug in a new class of medications called Nav1.8 inhibitors. Over the last twenty years, nine “Nav” or sodium channel subtypes have been identified in various parts of the body, including the heart, muscle and nerves. Only three subtypes, including Nav1.7, Nav1.8, and Nav1.9, are activated during pain and are located in peripheral tissue (peripheral nervous system). These channels are not found in the brain or central nervous system. Blocking or decreasing excitability of these specific sodium channels, while not impacting others, could lead to more targeted pain reduction, while limiting common side effects of less specific sodium channel agents like anticonvulsant and anesthetic medications. Drugs not affecting brain processing or cognition would lead to minimal risk of cognitive impairment, dizziness, dependence or addiction sometimes seen with opioid medications used for pain.
“Traditional anesthetics, like lidocaine, block sodium channels indiscriminately or non-selectively, so they can only be used topically due to potential side effects if swallowed or injected,” says Dr. Stanos. “Suzetrigine targets a sodium channel subtype, Nav1.8, that is located only in the peripheral nervous system and not the central nervous system or brain. Because the drug doesn’t enter your brain, it doesn’t trigger the potential mind-altering or euphoric effects associated with opioids. Studies with suzetrigine have confirmed that the drug does not cause cognitive impairment, craving or addiction, a serious potential side effect of opioids.
Research leads to innovation
The initial research for this new way to block or inhibit sodium channels involved the study of two unique family genetic mutations involving both hyperactive and non-functioning Nav1.7 sodium channel subtypes, according to Dr. Stanos. “Researchers examined and studied one US family with a rare genetic disorder caused by a mutation of their Nav1.7 sodium channel that caused their nerve fibers to be overactive and fire all the time," says Dr. Stanos. "They lived with constant burning pain all over their bodies. Another family in Pakistan had a different Nav1.7 sodium channel mutation that turned their sodium channel subtype off all the time. They felt no pain. Scientific study of these families helped to contribute to a better understanding of sodium channel subtypes (Nav1.7, Nav1.8, and Nav1.9) involved in pain and, in turn, develop this new class of medications.”
More recently, suzetrigine was tested in two large clinical trials. One looked at people undergoing a bunionectomy, and the other undergoing abdominoplasty, commonly known as a “tummy tuck.” “These two types of painful surgeries are commonly used to study analgesics or pain relievers since the pain is short-lived, measurable and predictable.”
Both trials showed that suzetrigine was as effective as Vicodin (hydrocodone combined with acetaminophen) and more effective than a placebo. Subjects did not have many of the central nervous system side effects associated with opioid pain relievers, such as nausea, drowsiness or addiction. The most common side effects were itching and muscle spasms.
Pain relief of the future?
Currently, suzetrigine is only FDA-approved to treat moderate to severe acute pain. However, several ongoing studies are looking at the drug’s potential for treating pain caused by damaged nerves, such as foot pain from diabetic neuropathy, osteoarthritis and lumbar radiculopathy or sciatica.
“This drug is the first of a number of potential Nav inhibitor drugs in development. These drugs may offer an alternative pathway to target pain reduction, and a relatively safer option given their non-addictive effects,” says Dr. Stanos.
Learn more and find a physician or advanced practice clinician (APC)
If you’re in pain, the team at Swedish Pain Services can help you better understand and manage your pain for lasting relief. Whether you require an in-person visit or want to consult a doctor virtually, you have options.
Contact Swedish Primary Care to schedule an appointment with a primary care physician. You can also connect virtually with your doctor to review your symptoms, provide instruction and follow up as needed.
And with Swedish ExpressCare Virtual, you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
