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Newly Approved Painkiller Provides Relief Without Addiction
Older patients may also benefit from decreased fall risk, less impact on cognitive function
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There’s a new way for doctors to treat the type of pain people experience following an injury or surgery — and it’s one that comes without the serious risks associated with prescription opioids.
The Food and Drug Administration (FDA) approved Journavx (suzetrigine) on Jan. 30, a first-in-its-class medication that works by blocking pain signals in the peripheral nerves, before they reach the brain. Opioids, in contrast, work directly in the brain and spinal cord, and are considered highly addictive because of their effect on the brain. It's the first new type of pain medication to be approved in more than two decades.
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Journavx, an oral pill, is approved to treat acute pain, which is the type of short-term pain that typically stems from tissue injury as a result of trauma or surgery. More than 80 million Americans are prescribed medication for acute pain each year, according to Vertex Pharmaceuticals, the maker of Journavx, and about half of them receive opioids.
Even short-term opioid use can lead to addiction, Mayo Clinic says, and it’s impossible to know who will develop a dependency.
“Today’s approval is an important public health milestone in acute pain management,” Jacqueline Corrigan-Curay, M.D., acting director of the FDA's Center for Drug Evaluation and Research, said in a news release. A non-opioid pain reliever “offers an opportunity to mitigate certain risks associated with using an opioid for pain and provides patients with another treatment option.”
The perils of opioids
More than 200 people, on average, died each day from an opioid overdose in 2022, according to data from the Centers for Disease Control and Prevention (CDC). Opioid use disorder can affect people of all ages, including older adults.
In two clinical trials, Journavax demonstrated statistically significant pain reduction in patients who had routine abdominal or foot surgeries, compared to a placebo. The most common side effects experienced by patients taking the pain pill were itching, muscle spasms, rash, and an increased level of creatine phosphokinase in the blood, which can signal stress or injury to the muscle.
“It’s going to play a significant role,” Jianguo Cheng, M.D., professor of anesthesiology and director of the Cleveland Clinic Multidisciplinary Pain Medicine Fellowship Program, says about Journavax. It doesn’t eliminate pain as well as a strong opioid, he explains, but “most people do not need very strong opioids, even for more severe pain.”
Benefits for older patients
Journavax may be especially helpful to older adults who seek common surgeries like hip and knee replacements, Cheng adds. Citing CDC data, the American Society of Anesthesiologists says 38 percent of surgeries in U.S. hospitals are performed on adults 65 and older, and that percentage is expected to increase.
What’s more, prescription opioid use can increase the risk of falls in older adults, research shows, as well as hurt cognitive function, Cheng says.
An observational study from Mayo Clinic researchers found that older adults who received opioids had a 20 percent higher chance of developing mild cognitive impairment, a condition where thinking and memory problems exceed typical age-related cognitive changes. This new drug may help some patients “avoid some of the negative cognitive impacts derived from opioids,” Cheng says.
Importantly, Edward R. Mariano, M.D., a professor of anesthesiology at Stanford Medicine, tells AARP that the newly approved medication gives doctors and patients another option for treating pain. “You can't really rely on any single class of medications, as we have in the past with opioids,” he says.
Journavax has a list price of $15.50 per 50 milligram pill. And while it’s only approved for acute pain now, it could be used for other types of pain in the future. Researchers are testing the medication in a late-stage trial in people who have diabetic peripheral neuropathy.
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