Non-addictive painkillers
For decades, patients seeking medication for pain have had two choices: over-the-counter drugs like aspirin or powerful prescription opioids like oxycodone.
Opioid prescriptions have plummeted over the last decade as doctors have become more attuned to the risks of addiction and misuse during the country’s ongoing drug epidemic.
Boston-based Vertex Pharmaceuticals recently reported positive results for a non-opioid painkiller, one of several medications it’s developing. Patients taking the drug after surgery experienced more pain relief than those getting a placebo, although the drug didn’t outperform opioids.
The Associated Press spoke with Vertex’s chief scientist, Dr. David Altshuler, about the company’s research and plans.
Why is Vertex interested in new drugs for treating pain?
There are medicines like Tylenol that are modestly effective but they’re very well tolerated. And there’s medicines such as opioids that are very effective but unfortunately have side effects, as well as addictive potential.
Identifying additional medicines that could be used for people who need more pain relief, but don’t want to take the risks of opioids, would be helpful for society.
How did you develop these drugs?
Vertex has been working on this for 20 years, and the insight that led to the medicines actually came from studies of people who had a rare condition where they are insensitive to pain. They can feel things, sense temperature, but do not feel pain. This was actually identified in a family of fire walkers who could walk on hot coals.
So scientists figured out that that condition was due to inherited differences in a particular protein. So if you lack this function, you don’t feel pain. So we and many others have worked for decades to make a medicine that could recapitulate that phenomenon.
Why wouldn’t these drugs carry the addictive properties of opioids?
Addictive medicines typically work in the brain and they have side effects that aren’t really separable from the reduction in pain, because they’re the same thing. That’s their mechanism of action.
Our goal is to make medicines that act in the periphery, not in the brain, so they wouldn’t have the same potential risk.
Tell me about the recent data you’ve reported?
We’ve reported three studies in people with acute pain — things like surgery or an injury. All three studies showed substantial reduction of pain of about 50%.
What comes next?
For acute pain, we’re preparing to file for FDA approval.
For the longer-term pain, it’s earlier in the development stage, but the data is encouraging so far. We’re continuing studies there to determine if it’s possible to apply for approval.