Suzetrigine: A New Way to Treat Pain?

The opioid epidemic is one of the most significant public health crises in the United States, affecting millions of individuals and communities across the nation. In 2023, there were an estimated 74,000 deaths from synthetic opioids with fentanyl being the primary agent. Over the past few decades, the widespread misuse and abuse of prescription pain medications, heroin, and synthetic opioids like fentanyl have led to a dramatic increase in overdose deaths, addiction, and related health problems. 

This crisis has strained healthcare systems, law enforcement agencies, and social services, highlighting the urgent need for comprehensive and effective solutions to address the complex issues associated with opioid addiction. Can a new pain medicine be the key to addressing pain management and the opioid epidemic? 

VX-548: A Potential Breakthrough in Pain Management

VX-548, also known as suzetrigine, is an investigational drug being developed by Vertex Pharmaceuticals, designed to provide relief from moderate-to-severe acute pain. Suzetrigine may offer a potential alternative to treating pain than traditional opioids.

How does it work? 

Suzetrigine is a selective sodium channel blocker that specifically inhibits NaV18. This particular channel is found in the peripheral nerves. The mechanism behind suzetrigine is unique due to the fact that it does not bind in the same way as opioids and therefore does not exert the same side effects that are widely experienced such as drowsiness and slow breathing. Furthermore, since it is considered a non-opioid analgesic, it will not contain the same risk of addiction as regular opioid medications. 

What is the potential impact? 

So far phase-2 clinical trials have shown promising results with reducing pain and tolerability. However, it is still undergoing development and has not been approved by the FDA but their submission for New Drug Application (NDA) has been accepted. They have also been granted FDA Fast Track and Breakthrough therapy.  

If approved, suzetrigine can offer a groundbreaking alternative to opioids, especially those at risk for addiction or overdose.

Pharmacists’ Role in Combating Opioid Addiction

While new drug developments for treating both chronic and acute pain without opioids are still on the horizon, pharmacists are uniquely positioned to play a pivotal role in combating the opioid addiction crisis. There are some key strategies that can be implemented in practice.

Patient Education and Counseling

Educate patients about the proper use, storage of opioid drugs. Screen patients for risk factors of addiction and provide counseling accordingly. Furthermore, discuss non-opioid pain management options, such as physical therapy and over-the counter analgesics.

Prescription monitoring and flagging

 It is imperative to find ways to monitor prescription patterns to identify signs of abuse and diversion. If you notice any strangeness occurring, report suspicious activity to the appropriate authorities or patient’s healthcare provider.

Naloxone distribution

Stocking and dispensing naloxone can help prevent overdose. In addition, it is imperative to train patients and their families on administering naloxone.

Medication Management Therapy (MTM) Services

MTMs might not be ideal depending on the setting of your pharmacy but can provide enormous benefits in being able to identify issues in patients’ pain medication regimen. This can also help assist patients off of opioids when appropriate.

Collaborative with Healthcare Providers

Work collaboratively with physicians and other healthcare providers to develop comprehensive pain management plans. Refer patients to addiction treatment programs or mental health services as needed.

Community Outreach

Participate in community outreach programs to raise awareness about the opioid crisis and its consequences. Promote harm reduction strategies, such as needle exchange programs, to reduce the risks associated with opioid use.

Pharmacists can play a direct role in helping to combat the opioid and overall substance use epidemic in the United States. In addition to finding alternative ways to treat pain, it is important to also understand the role that fentanyl has played as well. Knowing these vital pieces will help with the treatment of substance abuse and aid in overcoming the opioid crisis in the country.

References:

1. Centers for Disease Control and Prevention. (2024, May 15). U.S. overdose deaths decrease in 2023, first time since 2018. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm#:~:text=The%20new%20data%20show%20overdose,psychostimulants%20(like%20methamphetamine)%20increased 
2. Jones, J., Correll, D. J., Lechner, S. M., Jazic, I., Miao, X., Shaw, D., Simard, C., Osteen, J. D., Hare, B., Beaton, A., Bertoch, T., Buvanendran, A., Habib, A. S., Pizzi, L. J., Pollak, R. A., Weiner, S. G., Bozic, C., Negulescu, P., & White, P. F. (2023). Selective inhibition of na            v            1.8 with VX-548 for acute pain. New England Journal of Medicine, 389(5), 393–405. https://doi.org/10.1056/nejmoa2209870  
3. Vertex announces FDA acceptance of New Drug Application for suzetrigine for the treatment of moderate-to-severe acute pain. Vertex Pharmaceuticals. (2024, July 30). https://investors.vrtx.com/news-releases/news-release-details/vertex-announces-fda-acceptance-new-drug-application-suzetrigine  
4. Bach, P., & Hartung, D. (2019, September 2). Leveraging the role of Community Pharmacists in the prevention, surveillance, and treatment of Opioid Use Disorders – Addiction Science & Clinical Practice. BioMed Central. https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-019-0158-0#:~:text=Community%20pharmacists%20are%20ideally%20positioned,reduce%20the%20harms%20associated%20with