A Dive Into Oliceridine and Its Novel Mechanism of Action.

Anjali Shah,Germin Fahim,Lindsay A Brust-Sisti,Reema Shah

doi:10.7759/cureus.19076

Abstract

The current state of the opioid epidemic has revealed the need of utilizing proper pain management, especially in the postoperative setting where there is overuse of potent analgesics. However, the adequate treatment of pain is necessary to reduce mortality and cost of burden while increasing recovery and improving quality of life. Treatment of pain can be difficult to standardize as the guidelines from the American Pain Society discuss the importance of tailoring treatment options based on a patient’s sensitivities and risk factors. An effective fast-acting analgesic with adequate potency and few adverse events is the key to alleviating acute pain. Oliceridine (Olinvyk®, Trevena Inc., Chesterbrook, USA) is a novel G protein-biased μ-opioid receptor agonist designed to decrease opioid-related adverse events (ORAEs) compared to conventional opioids. This article discusses oliceridine’s novel mechanism of action and current place in therapy. After a literature search on clinicaltrials.gov, three clinical trials were analyzed to understand the safety and efficacy of oliceridine. These trials demonstrated a comparable efficacy to morphine with a decreased risk for serious adverse events. However, further studies need to be conducted to evaluate the true safety impact of oliceridine compared to conventional opioids.

Highlights

BackgroundPain is the unpleasant sensory and emotional experience associated with actual or potential tissue damage [1]
Through the ATHENA-1, APOLLO-1, and APOLLO-2 trials, oliceridine has demonstrated potential as an opioid with a new mechanism of action showing superior efficacy results compared to placebo, comparable efficacy results to morphine, and a favorable safety profile, but head to head studies comparing oliceridine and morphine are lacking
The exploratory studies were mainly focused on the impact of oliceridine on specific opioid-related adverse events (ORAEs), but as a whole, the phase 3 clinical trials conducted for oliceridine did not account for specific imbalances

Summary

Introduction

BackgroundPain is the unpleasant sensory and emotional experience associated with actual or potential tissue damage [1]. Pain can be classified as acute or chronic, each with different management options. Acute pain is characterized as being self-limiting, lasting less than three to six months with treatment focused on the use of analgesics. Postoperative pain is a type of acute pain occurring in patients after undergoing a procedure. There is a preconceived notion that acute pain will be relatively short-lived after a successful operation. Evidence suggests that less than half of patients who undergo surgery report adequate postoperative pain relief [2]. Inadequate acute pain management can transition to chronic pain through neuronal plasticity and increase mortality, delay recovery, and increase hospital costs [3]. This paper will review oliceridine (Olinvyk®, Trevena Inc., Chesterbrook, USA), its novel mechanism of action, and its role in pain management, especially with the current state of the ongoing opioid epidemic

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