KOL clinical experiences & perspectives on OLINVYK
The OLINVYK podcast series, featuring today's key opinion leaders, discusses a variety of topics relevant to the management of acute pain.
in Acute Postoperative Pain
The Case for IV Opioid Use in Acute Postoperative Pain
This episode discusses evolving clinical strategies in acute postoperative pain management with a focus on OLINVYK as an IV opioid option. Hear from Dr. Sabry Ayad, Professor of Anesthesiology at the Cleveland Clinic Lerner College of Medicine.
Pressure to reduce opioid use perioperatively has led to gaps in acute postoperative pain control.1,2 While IV opioids are still a critical component of recovery for some postoperative patients, there’s a clear need to balance pain control with minimizing the risk of adverse events.1-4 So how do surgeons and anesthesiologists maintain this balance, especially in clinically challenging patients?
Today, we’ll be discussing evolving clinical strategies in acute postoperative pain management, with a focus on a new treatment option, OLINVYK, the first IV opioid advancement in decades.5
And I’m your host Dr. Jennifer Caudle. And joining me is Dr. Sabry Ayad, Professor of Anesthesiology at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University in Cleveland, Ohio.
Dr. Ayad, welcome to the program.
Great to be with you!
Before we begin, let’s take a moment to review some important safety information about OLINVYK.
OLINVYK is an opioid agonist indicated in adults for the management of acute pain severe enough to require an intravenous opioid analgesic and for whom alternative treatments are inadequate.6 OLINVYK has a black box warning with risks of addiction, abuse, and misuse; life-threatening respiratory depression; neonatal opioid withdrawal syndrome; and risks from concomitant use with benzodiazepines or other central nervous system depressants.6
Dr. Ayad, to start, can you put the current landscape of acute postoperative pain management into perspective for us and the challenges that you and your colleagues face on your patients’ behalf?
- a) Thanks, Dr. Caudle. I think we first need to consider the current societal opioid crisis in context, since this crisis is both large and pervasive.1 But while it emanated largely from inappropriate prescribing, marketing, and misuse of oral prescription opioids,2 it’s become common in the current environment to lose sight of a key factor giving rise to this crisis, which is poorly controlled pain.1
- b) And this is very much an ongoing issue in surgery and anesthesiology since acute postoperative pain remains poorly treated.1 In a US survey of 300 adults who had undergone surgery within 5 years of the survey date, 75% reported experiencing moderate to severe postoperative pain.4 But unfortunately, despite this takeaway, we also know that more than 80% of postoperative patients report inadequate pain relief, and that metric has remained largely unchanged over the past 20 years.7
- c) So this underscores an important role that opioids still play for postoperative analgesia, especially for moderate to severe pain.3
But I take it, despite those takeaways, procedural practice is still complicated when it comes to the use of opioid analgesics, is that correct?
- a) That’s right. The opioid crisis has put an important emphasis on thoughtfully scrutinizing perioperative opioid use and prescribing, but what we’ve also seen is a trend toward precipitously reducing or eliminating opioid use in these settings altogether.1 And this has gone on despite there being no clear evidence that opioid-free strategies benefit patients above and beyond opioid-sparing strategies.8 Those aren’t synonymous terms or approaches, and it’s important to distinguish them in practice.
- b) Consider non-opioid analgesic agents such as acetaminophen, NSAIDs, local/regional analgesic techniques, and adjuncts such as steroids, gabapentinoids, and ketamine.8 In the setting of opioid-free analgesia, there is a ceiling effect with these agents and a small therapeutic index for safety8; and other than the local/regional analgesic options, we can’t titrate these agents to individual patient requirements, which is a necessity during the intraoperative period.8 These limitations can render non-opioid agents insufficient against moderate to severe pain.2
- c) So I think there’s a lot at stake here in the intraoperative and postoperative settings because, in my experience, if acute surgical pain isn’t managed promptly, it can be even more difficult to address later or when this acute pain turns into chronic pain.1 Some of the patients develop chronic pain following invasive procedures such as laminectomy, hernia repair, thoracotomy, and breast surgery, and these patients are very hard to manage. That’s why tackling acute surgical pain in a controlled surgical setting is extremely important.1
You mentioned some of your patients, Dr. Ayad. Can you give us a better sense of the patient populations and factors that influence your postoperative pain management decisions?
- a) Sure. In any assessment of acute postoperative pain management of our patients, we need to balance expected benefits with potential risks. And with IV opioids, that balance centers on delivering effective analgesia alongside acceptable tolerability.9 So we focus on risks of opioid-related adverse events, or ORAEs, such as nausea, vomiting, ileus, confusion or delirium, and the most serious side effect, respiratory depression.3
- b) And we’ve found that certain patient types may be at higher risk for these ORAEs, which can make for much more challenging clinical management.10
- c) A large, retrospective database analysis of patients who underwent inpatient surgical procedures and received conventional opioids found several factors that put patients at higher risk of opioid-induced respiratory depression, including comorbid obesity, respiratory conditions, sleep apnea, and older age.10
- d) Patients who are older, obese, and/or have multiple comorbidities are particularly challenging for us since they’re more likely to experience respiratory depression,10 so good providers need to keep these factors in mind when evaluating patients ahead of surgery.
And do these postoperative adverse events with conventional opioids impact healthcare systems as well?
- a) Absolutely. The care complications and close management required after patients experience ORAEs can also be associated with substantial increases in healthcare utilization.3
- b) A large, retrospective study that assessed clinical and administrative data of patients who underwent inpatient surgery and received opioids found a 25% increase in 30-day readmissions, a 30% increase in length of hospital stay, and a 47% greater total cost of hospitalization in patients who experienced an opioid-related adverse event.3
- c) So clearly, from both patient care and healthcare system standpoints, there’s an ongoing need to monitor patients carefully to reduce the risk of ORAEs.3
Well given this foundation you’ve provided on the clinical priorities and challenges concerning opioid use in surgical settings, I want to focus now on the emerging role of OLINVYK, which as we talked about earlier, represents the first IV opioid advancement in decades.5 Dr. Ayad, what makes this a novel treatment option among opioids, mechanistically?
- a) OLINVYK, or oliceridine, is a full opioid agonist that features what’s called a biased ligand technology which preferentially targets not just specific opioid receptors such as the μ-opioid receptor, but the specific signaling pathways downstream of those receptors.11,12 And this is a novel level of selectivity that may lead to a differentiated pharmacology.13,14
So let’s dive into that pharmacological profile for a moment. What are some key clinical characteristics that stand out for you regarding this treatment option?
- a) OLINVYK has been very well-studied from a strong clinical program consisting of more than 1900 patients.6,15-17
- b) Early phase trials have shown that OLINVYK has a rapid onset of analgesia, with the median onset of pain relief at one to three minutes after the first dose.6,18
- c) We talked about clinically challenging patients earlier, including the elderly, obese, and those with comorbidities. And based on the results of a phase 3 open-label study called the ATHENA trial,17 OLINVYK’s safety profile was established in these patient populations.6,17
- d) It also has no active metabolites, which provides a predictable level of analgesia and reduced dose stacking concerns.6,19
- e) Plus, with simple flexible dosing, there are no dose adjustments needed in patients with renal impairment,6,19 which is different from the conventional opioids that we use. So features like these are actually very exciting when seen in clinical practice.
You spoke to the ATHENA trial just now. Can you give us some more details on that study and what was uncovered there?
- a) Sure. ATHENA was a phase 3, multicenter, open-label clinical study that evaluated the safety and tolerability of OLINVYK in 768 patients with moderate to severe acute pain warranting the use of a parenteral opioid.6,17
- b) Treatment duration for each patient was determined by the clinical need for parenteral opioid therapy, but the maximum duration of treatment was limited to 14 days.17
- c) The “End of treatment” period was within 24 hours after the last dose of OLINVYK, while the posttreatment follow-up period was limited to 3 days unless any serious adverse events occurred, at which point that patient would be followed until it was resolved.17
- d) I mentioned an important differentiator in this study compared to what’s usually seen in controlled clinical trials, in that the ATHENA study population included a good representation of clinically challenging patients.6,17
- e) Many of these patients had a BMI greater than 30 and were older than 65, and all patients included in ATHENA had at least one underlying comorbidity, providing a good representation of what happens in the real world.6,17
- f) Many patients also received prophylactic antiemetics and multimodal analgesics such as acetaminophen, NSAIDs, or gabapentinoids along with OLINVYK.17 But those receiving OLINVYK didn’t receive other opioids during their treatment period.17
- g) The data from ATHENA showed that OLINVYK was very well tolerated.17 Most adverse events reported were mild or moderate in severity, and the most common ones were nausea, constipation, and vomiting.6
- h) Interestingly, the incidence of adverse events in the obese and elderly population was similar to that of the overall population,17 which was something that differentiated OLINVYK from what is seen in the literature with conventional opioids.20
- i) Only 2 percent of patients had adverse events leading to early discontinuation,17 and none of the patients receiving OLINVYK needed to use naloxone during treatment,17 which further highlights this treatment’s safety profile.
Great insights on that clinical trial, Dr. Ayad, thank you. Now, my last question to you: looking ahead, how do you see OLINVYK changing the practice of acute pain management where an IV opioid is needed, especially for patients with complex clinical needs?
- a) Well, from my vantage point, OLINVYK, with its unique pharmacology13,14 and established safety profile, is a new option to treat moderate to severe acute intraoperative or postoperative pain for the clinically challenging adult patients that I see in practice every day.
- b) So I think that adding OLINVYK to our ERAS protocols will be a very good way of enhancing our acute post-surgical pain management, and I’m looking forward to seeing the impacts of this treatment across all types of surgeries.
- c) But as a reminder, as with all opioids and other Black Box Warning products, there are certain risks associated with use, including respiratory depression, neonatal withdrawal syndrome, and the risk of misuse and addiction.
Well, with those forward-looking insights in mind, I very much want to thank my guest, Dr. Sabry Ayad, for helping us better understand the role of IV opioids in acute postoperative pain management, and the emergence of OLINVYK as a treatment option for clinically challenging patients.
Dr. Ayad, it was great speaking with you today.
It’s been a pleasure. Thank you so much.
References: 1. Kharasch ED, Avram MJ, Clark JD. Rational Perioperative Opioid Management in the Era of the Opioid Crisis. Anesthesiology. 2020;132(4):603-605. doi:10.1097/ALN.0000000000003166 2. Kharasch ED, Clark JD. Opioid-free Anesthesia: Time to Regain Our Balance. Anesthesiology. 2021;134(4):509-514. doi:10.1097/ALN.0000000000003705 3. Shafi S, Collinsworth AW, Copeland LA, et al. Association of Opioid-Related Adverse Drug Events with Clinical and Cost Outcomes Among Surgical Patients in a Large Integrated Health Care Delivery System. JAMA Surg. 2018;153(8):757-763. doi:10.1001/jamasurg.2018.1039 4. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014;30(1):149-160. doi:10.1185/03007995.2013.860019 5. Trevena, Inc. Data on File; 2020. 6. Trevena, Inc. OLINVYK [Prescribing Information].; 2021. 7. Gan TJ: Poorly controlled postoperative pain: Prevalence, consequences, and prevention. J Pain Res 2017;10:2287-98. 8. Shanthanna H, Ladha KS, Kehlet H, Joshi GP: Perioperative opioid administration: A critical review of opioid-free versus opioid-sparing approaches. Anesthesiology 2021;134:645-59 9. Smith HS. Opioid metabolism. Mayo Clin Proc. 2009;84:613-624. 10. Oderda GM, Senagore AJ, Morland K, et al. Opioid-related respiratory and gastrointestinal adverse events in patients with acute postoperative pain: prevalence, predictors, and burden. J Pain Palliat Care Pharmacother. 2019;33(3-4):82-97. doi:10.1080/15360288.2019.1668902 11. Benovic JL. G-protein-coupled receptors signal victory. Cell. 2012;151(6):1148-1150. 12. Violin JD, Crombie AL, Soergel DG, Lark MW. Biased ligands at G-protein-coupled receptors: promise and progress. Trends Pharmacol Sci. 2014;35(7):308-316. doi:10.1016/j.tips.2014.04.007 13. Schmid CL, Kennedy NM, Ross NC, et al. Bias Factor and Therapeutic Window Correlate to Predict Safer Opioid Analgesics. Cell. 2017;171(5):1165-1175.e13. doi:10.1016/j.cell.2017.10.035 14. Siuda ER, Carr R, Rominger DH, Violin JD. Biased mu-opioid receptor ligands: a promising new generation of pain therapeutics. Curr Opin Pharmacol. 2017;32:77-84. doi:10.1016/j.coph.2016.11.007 15. Viscusi ER, Skobieranda F, Soergel DG, Cook E, Burt DA, Singla N. APOLLO-1: a randomized placebo and active-controlled phase III study investigating oliceridine (TRV130), a G protein-biased ligand at the µ-opioid receptor, for management of moderate-to-severe acute pain following bunionectomy. J Pain Res. 2019;12:927-943. doi:10.2147/JPR.S171013 16. Singla NK, Skobieranda F, Soergel DG, et al. APOLLO-2: A Randomized, Placebo and Active-Controlled Phase III Study Investigating Oliceridine (TRV130), a G Protein-Biased Ligand at the μ-Opioid Receptor, for Management of Moderate to Severe Acute Pain Following Abdominoplasty. Pain Pract. 2019;19(7):715-731. doi:10.1111/papr.12801 17. Bergese SD, Brzezinski M, Hammer GB, et al. ATHENA: A Phase 3, Open-Label Study Of The Safety And Effectiveness Of Oliceridine (TRV130), A G-Protein Selective Agonist At The µ-Opioid Receptor, In Patients With Moderate To Severe Acute Pain Requiring Parenteral Opioid Therapy. J Pain Res. 2019;12:. doi:10.2147/JPR.S217563 18. Viscusi ER, Webster L, Kuss M, et al. A randomized, phase 2 study investigating TRV130, a biased ligand of the μ-opioid receptor, for the intravenous treatment of acute pain. Pain. 2016;157(1):264-272. doi:10.1097/j.pain.0000000000000363 19. Gan TJ, Wase L. Oliceridine, a G protein-selective ligand at the μ-opioid receptor, for the management of moderate to severe acute pain. Drugs Today (Barc). 2020;56(4):269-286. doi:10.1358/dot.2020.56.4.3107707 20. Gupta K, Prasad A, Nagappa M, Wong J, Abrahamyan L, Chung FF. Risk factors for opioid-induced respiratory depression and failure to rescue: a review. Curr Opin Anaesthesiol. 2018. Feb;31(1):110-119.
Expert Perspectives in Acute Pain Management Strategies
and Advancements in Care
In this episode, experts share their experience using OLINVYK for surgical cases, as well as its intravenous dosing and use in postoperative cases. Hear from Dr. Timothy Beard, a general surgeon from Summit Medical Group in Bend, Oregon and faculty member at Oregon Health and Sciences University and Dr. Joseph Answine, an anesthesiologist from Harrisburg, Pennsylvania and faculty member at Penn State University.
Welcome. Today, we’ve got a great program discussing acute pain management strategies in perioperative care with two leading experts: Dr. Joseph Answine, an anesthesiologist, and Dr. Timothy Beard, a general surgeon. This program is intended for US healthcare professionals.
I’m your host, Dr. Barbara Joy Jones.
Advancing age. Obesity. Renal impairment. Comorbidities such as these are just a few of the more common patient characteristics that can complicate perioperative care and acute postoperative pain management.
When opioid-free multimodal analgesia is not sufficient, what clinical gaps exist in the use of conventional IV opioids with these clinically challenging patients? And can OLINVYK®, also known as oliceridine, injection, the first IV opioid advancement in decades,1 be considered the turning point for the IV opioid class?
Joining me today are Drs. Timothy Beard and Joseph Answine to share their perspectives on this important topic.
Dr. Beard is a general surgeon and certified by the American Board of Surgery and a Fellow of the American College of Surgeons. He works for Summit Medical Group in Bend, Oregon and holds a faculty position at Oregon Health and Sciences University. Dr. Beard, welcome to the program.
Thank you. Happy to be here.
Dr. Answine is an anesthesiologist in Harrisburg, Pennsylvania and is part of a large, private practice group. He holds an active teaching appointment at Penn State and is affiliated with multiple hospitals in the area, including UPMC Pinnacle and Penn State Health Milton S. Hershey Medical Center. Dr. Answine, it’s great to have you here today.
And it's great to be here. Thank you for giving me the opportunity to speak to you.
Before we begin, let’s take a moment to review some important safety information.
OLINVYK is an opioid agonist indicated in adults for the management of acute pain severe enough to require an intravenous opioid analgesic and for whom alternative treatments are inadequate. OLINVYK has a boxed warning with risks of addiction, abuse and misuse; life-threatening respiratory depression; neonatal opioid withdrawal syndrome; and risks from concomitant use with benzodiazepines or other central nervous system depressants.2
Dr. Answine, let’s start with you. Can you tell us about your anesthesiology practice and how it’s informed your current views on acute pain management?
- a) Sure. I’ve been a practicing anesthesiologist at a private practice in Pennsylvania for twenty-nine years, and I also have an active teaching appointment at Penn State. I specialize in treating morbidly obese patients, and as you can imagine, many of them develop additional comorbidities, such as advanced cardiac disease. These are the patients I consider to be clinically challenging. Their condition or advanced disease state oftentimes requires surgery or another type of painful intervention3 such as open abdominal procedures or thoracotomies. Procedures such as these cause deep, visceral pain, and opioid-free multimodal analgesia is simply not enough in these cases. The intense postoperative pain in these types of procedures requires IV-opioid-level pain control.
- b) Clinically challenging patients and the procedures they undergo can cause additional concerns in the operating room and the PACU.4 That’s because these patients are at greater risk for opioid-related adverse events such as nausea, vomiting, and respiratory depression. These risks can make managing severe acute pain in clinically challenging patients quite difficult.
Thanks, Dr. Answine. That paints a very clear picture of some of the difficulties you face in your practice today. Clearly, if IV opioids are still needed in certain patient types and procedures, an unmet need persists in the IV opioid class.
Dr. Beard, are you seeing similarities in your practice today?
- a) In my practice, I handle a wide variety of cases, and I agree with Dr. Answine that in looking back over the years, the trends show that patients are becoming more high-risk; and what I mean by that is, the patients I’m treating today are more challenging because of their conditions and comorbidities.
- b) The changing demographic of our patient populations has also coincided with an increased overall demand for surgical and postoperative care.4 We’ve seen a shift in the setting and number of surgeries performed. And more recently, we’ve been moving more surgical patients from hospitals to outpatient surgery centers. This is both a testament to advances in surgical care and a logistical necessity based on continuing growth in surgical volume despite limited hospital capacities.4
- i) For example, I may see a patient who is morbidly obese and develops an inflamed gallbladder that requires a laparoscopic cholecystectomy. This otherwise complicated procedure is now being shifted to the outpatient setting. For these clinically challenging patients, a procedure like this would have previously only been performed in the hospital or inpatient setting. And I’m seeing more and more of this in my practice.
- c) And there are even greater issues facing healthcare today as we navigate the COVID-19 pandemic. There are millions of backlogged procedures due to limiting elective procedures to prevent spread of infection.5
- d) While an outpatient setting is designed to handle patient and surgical volume, it is crucial that acute pain in these settings is managed effectively to ensure timely recovery and discharge while mitigating risks for adverse events.
Well, given the clinically challenging patient population you are both seeing in practice, and the demands placed on healthcare professionals and the healthcare system at large, let’s turn our attention to a novel treatment option, OLINVYK, and its theorized mechanism of action.
Dr. Answine, as a preface, what do we know about the science behind OLINVYK?
- a) The science behind OLINVYK, also known as oliceridine, is based on Nobel Prize-winning chemistry in biased ligand technology.6 This emerging science is a major development for the IV opioid class. Biased ligand technology allows for the preference of the G-protein pathway over B-arrestin at the mu-opioid receptor.7,8 OLINVYK is a full-opioid agonist that is relatively selective for the mu-opioid receptor, a G-protein-coupled receptor, or GPCR.2,9 This kind of selectivity has the potential to have a significant impact on opioid therapeutic pharmacology.8,10
- b) However, it is important to recognize that the clinical evidence to support this hypothesis isn’t yet fully established in humans. Having said that, any advancement to the IV opioid class is exciting given the safety profile and reputation of conventional IV opioids.
Thank you for that Dr. Answine. It’s been a long time since we’ve seen any major improvements to the class. Dr. Beard, how do you see OLINVYK advancing IV opioids and impacting acute pain management strategies?
- a) Let me start by sharing my experience. When I do colon resections, I typically use a medication with patients to offset or minimize the side effects of IV opioids. More specifically, I’m using anti-nausea medications prophylactically at the same time I am administering an IV opioid to manage pain. Essentially, it is like administering a treatment for the treatment. So, to me it is very exciting to see an advancement to the IV opioid class as the science progresses. OLINVYK feels like a step in the right direction.
- b) The most striking feature about OLINVYK is its rapid onset of action—approximately 1 to 3 minutes after the initial dose, with a half-life of 1.3-3 hours.2 I think this is a key feature that we’re very excited about. The idea is that we would be able to give patients OLINVYK intra-operatively and then postoperatively. In fact, we’re currently exploring this in our outpatient surgery center and the goal is to minimize patient recovery time. Postoperative patients are uncomfortable, and a fast onset of relief could potentially help them reach their next milestone.
Thank you, Dr. Beard. Dr. Answine, can you elaborate on how the safety and tolerability for OLINVYK was studied?
- a) Sure. What we know about OLINVYK is that its safety and tolerability have been well-established through a strong clinical development program which included not only the traditional blinded placebo-controlled trials, but also an open-label safety study called ATHENA.
- b) And what I like about the ATHENA study is that it reflects the real world—what I see in my practice. This study was a phase 3, open-label study that evaluated the safety and tolerability of OLINVYK in over 700 patients.2,11 Many of these patients had BMIs over 30, were older than 65, and all patients had at least one underlying comorbidity.2,11
- c) The data from ATHENA showed that OLINVYK was very well tolerated. Most adverse events reported were mild or moderate in severity, and the most common ones were nausea, constipation, and vomiting. For our patients, by far the most serious complication that we are concerned about is opioid-induced respiratory depression. It is compelling that in this study in over 700 patients, when given as part of a multimodal analgesic regimen, there was not a single use of naloxone in patients taking OLINVYK.11 That’s really interesting data in my estimation.
- d) And it’s great to see data that show that OLINVYK was well tolerated, with less than 5% of patients discontinuing from lack of efficacy and only 2% of patients discontinuing use due to adverse events.11
Having a large safety study reflective of real-world patients as part of its clinical development program is impressive. Dr. Beard, what has been your clinical experience with OLINVYK? What are you seeing with your patients?
- a) We’re starting to use OLINVYK on our high-risk laparoscopic cases at our outpatient surgery center. In the past, we were using a multi-modal pain management strategy, and we’d give IV opioids when needed, but you’re running a fine line with these clinically challenging patients on how much you can give. A high volume of patients move through our surgery center and managing recovery can be difficult when using conventional IV opioids with these types of patients. We cannot have patients in recovery for hours at a time.
- b) Now with OLINVYK, we’re still using the multi-modal approach but including OLINVYK in the operating room as well as postoperatively. We’re giving a milligram in the OR intra-operatively and then another one or two milligram bolus in the recovery room. In our experience using this approach we are not seeing nausea and respiratory events in our patients the way we’ve witnessed it in the past. Patients are recovering quickly, and able to be discharged in a reasonable amount of time. This trend suggests that as we gain experience with OLINVYK, we potentially will be able to handle more clinically challenging patients in both outpatient and inpatient settings.
- c) And I just want to echo what Dr. Answine said about how none of the patients receiving OLINVYK required naloxone in the ATHENA trial11—that’s quite remarkable. Because currently in our hospital, which is average-sized, we still probably have two or three near-codes a month where people have to get naloxone.
Thank you, Dr. Beard. Dr. Answine, let me turn to you for the final word as we close out our program. What is your personal perspective on the clinical value that OLINVYK brings and its role in the ERAS protocols?
- a) Right now, our postoperative recovery guidelines are shaped by ERAS protocols that focus on opioid-sparing analgesia, and we’re going to continue to do that. But many of our clinically challenging patients will likely need IV opioids to address their severe acute postoperative pain.
- b) As with all opioids and other boxed warning products, we have to remain vigilant against known risks associated with use, such as respiratory depression, neonatal withdrawal syndrome, and the risk of misuse, abuse, and addiction.
- c) But considering how promising OLINVYK is, particularly for our clinically challenging patients, both in terms of the safety and tolerability and rapid efficacy in pain relief,2,11 I think there’s a strong case to be made for adding it to our ERAS protocols to give healthcare professionals another option to do what is best for their patients.
Those are meaningful insights to consider as we come to the end of today’s program. With that, I want to thank my guests, Drs. Timothy Beard and Joseph Answine, for sharing their perspectives on the acute pain management landscape with respect to clinically challenging patients, and the role of OLINVYK within the IV opioid class given its clinical profile.
Dr. Beard and Dr. Answine, it was great speaking with you both.
Thank you. Thanks for having me.
Well thank you. It was great speaking with you as well.
References: 1. Data on file. Trevena, Inc; 2020. 2. OLINVYK. Prescribing information. Trevena, Inc; 2021. 3. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014;30(1):149-160. 4. American Hospital Association. Trendwatch Chartbook 2020: Supplementary Tables and Data: Utilization and Volume. https://www.aha.org/system/files/media/file/2020/10/TrendwatchChartbook-2020-Appendix.pdf. Accessed October 7, 2021. 5. Berlin G, Bueno D, Gibler K, Schulz J. Cutting through the COVID-19 surgical backlog. McKinsey & Company. October 2, 2020.. Accessed October 7, 2021. 6. Benovic JL. G protein couple receptors signal victory. Cell. 2012;151(6):1148 1150. 7. Violin JD, Crombie AL, Soergel DG, Lark MW. Biased ligands at G-protein-coupled receptors: promise and progress. Trends Pharmacol Sci. 2014;35(7):308-316. 8. Schmid CL, Kennedy NM, Ross NC, et al. Bias factor and therapeutic window correlate to predict safer opioid analgesics. Cell. 2017;171(5):1165-1175.e13. 9. DeWire SM, Yamashita DS, Rominger DH, et al. A G protein-biased ligand at the µ-opioid receptor is potently analgesic with reduced gastrointestinal and respiratory dysfunction compared with morphine. J Pharmacol Exp Ther. 2013;344(3):708-717. 10. Siuda ER, Carr R, Rominger DH, Violin JD. Biased mu-opioid receptor ligands: a promising new generation of pain therapeutics. Curr Opin Pharmacol. 2017;32:77-84. 11. Bergese SD, Brzezinski M, Hammer GB, et al. ATHENA: a phase 3, open label study of the safety and effectiveness of oliceridine (TRV130), a G protein selective agonist at the µ opioid receptor, in patients with moderate to severe acute pain requiring parenteral opioid therapy. J Pain Res. 2019;12:3113 3126.
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