Adam’s Journal
Here’s a question from an Oklahoma Medical Research Foundation coworker:
Last month, the Food and Drug Administration approved Journavx, a new drug to treat pain. I read that it is the first new prescription pain medication in more than 25 years. That sounds like a big deal. Is it?
Brent Keck
Dr. Scofield Prescribes
I think so.
What makes this new drug different is that it works only on nerves outside the brain, blocking pain signals. This seems to mean that, unlike opioids, which attach to receptors on nerve cells in the brain, it cannot become addictive.
But let me be clear about this: We can’t know for sure this new drug is nonaddictive. Indeed, when oxycodone and similar opioids were first approved, their spokespeople claimed that addiction was rare and that long-term use was safe and effective.
Of course, we now know the opposite is true. So, to avoid repeating past mistakes, we should proceed with great caution.
That said, scientists believe Journavx will be the first of a new wave of similar medications, ones that are both nonaddictive and powerful pain relievers.
In a pair of clinical trials each with roughly 1,000 patients who had pain from surgery, researchers randomly assigned subjects to receive the new drug, a placebo, or Vicodin, which consists of acetaminophen (Tylenol) and the opioid hydrocodone. Subjects reported that the drug had side effects similar to the placebo but eased pain as well as Vicodin.
People who participated in the trials didn’t report any of the unpleasant side effects of opioids, which include nausea, drowsiness and constipation. The drugs also appear to block pain as well as opioids – but without seeming to pose opioids’ risk of addiction.
Unfortunately, Journavx is quite expensive, with a list price of $15.50 a pill. Patients are expected to take two pills a day, for a daily cost of $31. Meanwhile, Vicodin retails for pennies per pill.
Right now, the FDA has approved the new drug to treat pain from an injury or surgery. Its manufacturer is also testing it for types of nerve pain, including diabetic neuropathy and sciatica. Preliminary results have been more promising in neuropathy, but the company is proceeding with studies for both.
Regulators will closely monitor the drug’s results as more patients take it. We’ll hope it proves as effective and nonaddictive as trials have indicated. If so, I’d expect to see more drugs like it reach the market, which over time should help reduce prices.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
