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Biopharma Takes Aim at Opioid Abuse

February 13, 2017

Next-generation painkillers in development are non-addictive

One in three Americans – roughly 100 million people – report suffering from some type of pain, according to the National Academy of Science’s Institute of Medicine. That’s more people than suffer from diabetes, cancer and heart disease combined.

Opioids are the gold standard for treating moderate to severe pain, with 250 million opioid prescriptions filled across the country each year.

But after the recent presidential election shined a spotlight on how addiction to painkillers is ravaging small, rural communities in New Hampshire and beyond, Americans are increasingly aware of an epidemic of abuse that often starts with acute use after painful surgery.

“Despite advances in technology, abuse deterrent hasn’t worked,” said Corey Davis, managing director of H.C. Wainwright. “Believe it or not, heroin is cheaper than prescription medication to treat pain.”

On Monday at the 2017 BIO CEO & Investor Conference in New York, Davis moderated a panel on next-generation pain control that spotlighted what biopharmaceutical companies are doing to combat opioid abuse by developing new medications without the euphoria and other addictive side effects of traditional painkillers.

“We’re very cognizant of some of the problems opioids have led to,” said Gail Cawkwell, Chief Medical Officer of Purdue Pharma, the maker of Oxycontin. “We’re working to educate prescribers to encourage appropriate use. We’ve delinked our sales reps’ compensation from volume. And we’ve investing in non-opioid analgesics.”

Cawkwell said the company’s efforts to diversify into non-opioid palliatives includes ongoing development of a first-in-class TrkA inhibitor for the treatment of chronic pain. TrkA is a member of a larger family of important signaling proteins that could produce a non-addictive alternative to opioids.

Jeffrey Kindler, CEO of Centrexion, says his company has developed a “robust pipeline” of non-addictive injectables, topicals and pills to treat pain emanating from a variety of conditions. Kindler says one of the company’s most encouraging products in development is an injectable that treats osteo-arthritis knee pain using capsaicin, a secondary metabolite produced by chili peppers.

“The challenge has been in administering the treatment, which itself can cause some pain, just like chili peppers in your mouth,” Kindler said. “For many people, it hasn’t been worth the pain, no pun intended. But now we think we’ve found a sweet spot of modest or tolerable amount of discomfort that makes it well-worth it for the powerful long-term effect.”

Centrexion is also working on pain medication for canines and to treat a rare foot condition.

Derek Chalmers, CEO of Cara Therapeutics, is working to change the way acute pain, chronic pain and pruritus – a severe itching of the skin – is treated. His company is developing new therapies that target the body’s peripheral nervous system to treat moderate-to-severe pain without inducing many of the undesirable side effects of medicines currently on the market.

“We’ve heard anecdotal stories of people [in clinical trials] leaving their house for the first time in years,” Chalmers reports.

Russell Herndon, CEO of Hydra Biosciences, says his company is focused on peripherally active molecules as a non-addictive painkiller. The company specializes in ion channel physiology to treat indications like painful diabetic neuropathy by reducing neural activity sending pain signals to the brain in a way that does not cause numbness, a reduction in tactical sensations, or a loss of sensitivity to hot and cold.”

“There’s a huge need for alternative treatment for chronic pain,” Herndon says. “Millions of patients are suffering and need access to pain relief. It’s so expensive to develop new pain medication, so we’re hoping to find more investment to bring these non-addictive, next-generation therapies to market.”