Amie SoloskyWith the news of the first-in-class non-opioid pain reliever being approved by the FDA, you may be wondering how it works and why it took so long for this type of pain reliever to reach the market in the first place.
To begin to understand non-opioid pain relievers, we need to understand pain. Pain is a sensation we feel when the body is warning us of a potential (or actual) injury for survival. However, pain is subjective and can occur even when we are not in real danger, such as after a major surgery. For decades, doctors have been prescribing opioid pain relievers post operation due to their efficacy and reliability in stopping these pain signals from the brain, despite their known addiction risks.
Opioids work by binding to receptors in the brain, spinal cord, and peripheral nervous system that block pain messages from the body. However, they can also boost feelings of pleasure due to the release of dopamine throughout the body after binding, which is why they are highly addictive. In 2023, close to 8.6 million Americans reported misusing prescription opioids in the past year, according to SAMHSA.
Since opioids are highly addictive, researchers have been investigating other solutions that could replace them. Suzetrigine, the new FDA-approved non-opioid drug, is the first of its kind that targets a sodium channel involved in pain signaling called Nav1.8. There are nine subtypes of sodium channels, and Nav1.8 is one of two that are active outside the brain.
Targeting these sodium channels for pain relief is not new. In fact, you may be familiar with the drug Novocaine, which the dentist will inject into your gums to numb the area before filling a cavity. The difference between Novocaine and Suzetrigine is that the first has to be injected to the region of expected pain due to its lack of selectivity for Nav1.8, resulting in the drug targeting all of the sodium channels and causing unwanted side effects if not localized. Suzetrigine, however, is very selective for inhibiting the Nav1.8 sodium channel. In the phase III clinical trial, Suzetrigine was effective for managing pain for more than 80% of participants and even had fewer side effects than the placebo group.
Suzetrigine is a promising new drug because it does not enter the brain the way that opioids do, resulting in it being non-addictive, and it is more selective than previous pain relievers. However, the search for alternatives to opioids is not over yet, as this new drug has not been proven to be effective for chronic pain, only acute. This is just the beginning of non-opioid pain relief.
Peer Editor: Luvna Dhawka
