Q&A: How Cebranopadol Could Help Address Gaps in Pain Management

Many gaps continue to persist in pain management, which lead to negative patient outcomes. When pain is not adequately managed, it can have a long-term impact on patient physiological and psychological health, and can even develop into chronic pain. But cebranopadol, an investigational first-in-class dual-NMR agonist, has shown promising efficacy and safety in various clinical studies, and could potentially help address some of those gaps.

Q&A: How Cebranopadol Could Help Address Gaps in Pain Management / TensorSpark - stock.adobe.com

In a recent interview with Drug Topics, Albert Dahan, MD, PhD, professor of anesthesiology at Leiden University Medical Center, discussed how cebranopadol is different from traditional opioids, how it will fit into the broader landscape of pain management therapies, current gaps that exist in pain management and how the therapy might help address them, and what the next steps are for cebranopadol.

To watch the full interview with Albert Dahan, click here and sign up for free access.

Drug Topics: How do you envision cebranopadol fitting into the broader landscape of pain management therapies?

Albert Dahan, MD, PhD: There is the tendency towards lesser drugs that induce all these deleterious effects like addiction and respiratory depression, and respiratory depression is the cause of the opioid crisis that currently affects the United states but not only the United, states by the way. There will be an intravenous, injectable formulation [of cebranopadol] and there will be tablets, so in the future, I foresee this drug to be used, for example, for postoperative pain relief, but also for treatment of chronic pain, in which you use it as a tablet, let's say once or twice a day.

This is a very slowly acting drug, so if you use it let's say twice a day or once a day, you might already have sufficient pain relief at the correct dose. But this is a very interesting concept that you have a drug that produces a potent analgesic, potent pain relief and can be used in various settings, in the acute pain setting, perioperatively and also the chronic pain setting. It is a drug with a lesser likelihood of respiratory depression and that is important, I believe.

Drug Topics: Can you talk about some of the current gaps in pain management and how cebranopadol might help address them?

Dahan: There is an unmet need, a really great unmet need, for drugs that produce very potent analgesia but with a reduced side effect profile. I'm very interested in that concept. On the one hand, you have a drug that produces lots of pain relief but often coinciding with lots of side effects like nausea, vomiting, constipation, likelihood of abuse, addiction etcetera, etcetera. We're looking for a drug that has a different balance. I look at those balances, efficacy versus adverse effects, within the concept of utility function, which is a concept from economics. Everything that we do in life gives us something positive, for example, if we buy bread, we are able to eat but it costs us money. There's always the balance between wanted effect, which is positive, and a negative effect.

We're looking for drugs that have a positive utility, in which the wanted effect, the positive effect, is much greater than the negative effect. For instance, for oxycodone, this balance is rather negative. But for a drug like cebranopadol, the balance is much more equal. So, this is an unmet need, which we develop drugs that are potent analgesics but without adverse effects, so that the utility function tends to be around 0, or better, even be positive. To be honest, in my own experience, I have rarely seen a drug that people call an opioid, like morphine, oxycodone, that is without side effects or that has a very positive utility.

READ MORE: Pain Management Resource Center

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