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J Pain Res. 2017 Oct 6;10:2413-2424. doi: 10.2147/JPR.S137952. eCollection 2017.

A randomized, Phase IIb study investigating oliceridine (TRV130), a novel µ-receptor G-protein pathway selective (μ-GPS) modulator, for the management of moderate to severe acute pain following abdominoplasty.

Author information

1
Lotus Clinical Research, Pasadena, CA.
2
Memorial Hermann Memorial City Medical Center, Houston, TX.
3
Trevena, Inc, King of Prussia, PA, USA.

Abstract

BACKGROUND:

Oliceridine (TRV130), a novel μ-receptor G-protein pathway selective (μ-GPS) modulator, was designed to improve the therapeutic window of conventional opioids by activating G-protein signaling while causing low β-arrestin recruitment to the μ receptor. This randomized, double-blind, patient-controlled analgesia Phase IIb study was conducted to investigate the efficacy, safety, and tolerability of oliceridine compared with morphine and placebo in patients with moderate to severe pain following abdominoplasty (NCT02335294; oliceridine is an investigational agent not yet approved by the US Food and Drug Administration).

METHODS:

Patients were randomized to receive postoperative regimens of intravenous oliceridine (loading/patient-controlled demand doses [mg/mg]: 1.5/0.10 [regimen A]; 1.5/0.35 [regimen B]), morphine (4.0/1.0), or placebo with treatment initiated within 4 hours of surgery and continued as needed for 24 hours.

RESULTS:

Two hundred patients were treated (n=39, n=39, n=83, and n=39 in the oliceridine regimen A, oliceridine regimen B, morphine, and placebo groups, respectively). Patients were predominantly female (n=198 [99%]) and had a mean age of 38.2 years, weight of 71.2 kg, and baseline pain score of 7.7 (on 11-point numeric pain rating scale). Patients receiving the oliceridine regimens had reductions in average pain scores (model-based change in time-weighted average versus placebo over 24 hours) of 2.3 and 2.1 points, respectively (P=0.0001 and P=0.0005 versus placebo); patients receiving morphine had a similar reduction (2.1 points; P<0.0001 versus placebo). A lower prevalence of adverse events (AEs) related to nausea, vomiting, and respiratory function was observed with the oliceridine regimens than with morphine (P<0.05). Other AEs with oliceridine were generally dose-related and similar in nature to those observed with conventional opioids; no serious AEs were reported with oliceridine.

CONCLUSION:

These results suggest that oliceridine may provide effective, rapid analgesia in patients with moderate to severe postoperative pain, with an acceptable safety/tolerability profile and potentially wider therapeutic window than morphine.

KEYWORDS:

TRV130; acute pain; analgesic; biased ligand; opioid

Conflict of interest statement

Disclosure This study was supported by Trevena, Inc (King of Prussia, PA, USA). Neil Singla is an employee of Lotus Clinical Research, LLC, contracted by the sponsor to conduct the study; Dr Singla has also received consulting fees from Trevena, Inc. Harold S Minkowitz has received investigator fees and consulting fees from Trevena, Inc, AcelRx, and The Medicines Company. Ruth Ann Subach was an employee of Trevena, Inc, during the conception/conduct of the study and owns Trevena, Inc, stock. David G Soergel, David A Burt, Monica Y Salamea, Michael J Fossler, and Franck Skobieranda are employees of the study’s sponsor, Trevena, Inc. The authors report no other conflicts of interest in this work.

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