CHESTERBROOK, PA — Trevena, Inc. (Nasdaq: TRVN), a biopharmaceutical company focused on the development and commercialization of novel medicines for patients with central nervous system (CNS) disorders, announced the publication of a new analysis of respiratory safety data from the OLINVYK Phase 3 multi-site “real world” safety study in Pain and Therapy.
The publication is titled, “Low Incidence of Opioid-Induced Respiratory Depression Observed with Oliceridine Regardless of Age or Body Mass Index: Exploratory Analysis from a Phase 3 Open-Label Trial in Postsurgical Pain,” with lead author Marek Brzezinski, M.D., Ph.D., Professor of Clinical Anesthesia, University of California San Francisco (DOI: https://doi.org/10.1007/s40122-020-00232-x).
Respiratory depression is a known risk of treatment with any opioid. Trevenastates that the results of this analysis highlight no statistically significant difference in the incidence of opioid-induced respiratory depression (OIRD) between elderly and younger patients, or between obese and non-obese patients, all of whom received OLINVYK. Advanced age and obesity are two well-recognized risk factors for developing OIRD.
“Pain management with IV opioids remains a key strategy for optimal analgesic management in the postoperative setting. However, dose-limiting adverse effects, including respiratory depression, represent a major limitation to their safe and effective use – particularly in high-risk patients with medical comorbidities,” said Dr. Brzezinski. “These findings are important and will serve as useful information for clinicians as they consider treatment options for their challenging patients.
Publication Key Points:
- Elderly patients (≥ 65 years) demonstrated no statistically significant difference in OIRD incidence compared to younger patients (10.8% vs. 15.1%, p=0.11).
- Obese patients (BMI ≥ 30) demonstrated no statistically significant difference in OIRD incidence compared to non-obese patients (14.0% vs. 13.4%, p=0.80).
- Patients that were both elderly and obese (n=120) demonstrated a relatively low OIRD incidence of 10.8%, which was numerically lower than the overall OIRD incidence of 13.7% in all patients.
- Out of 724 patients in the study, 33% were ≥ 65 years of age and 46% had a BMI of ≥ 30 kg/m2. The average age in the elderly group was 71 vs. 46 years in the younger age group. The average BMI in the obese group was 36.7 kg/m2 vs. 25.3 kg/m2 in the non-obese group.
- 52% of all patients received OLINVYK by bolus dosing and 48% by patient-controlled analgesia (PCA). The median cumulative dose of OLINVYK was 21 mg with a median duration of exposure of 21.4 hours.
- Overall, 13.7% of all patients experienced OIRD defined by a respiratory rate <10 bpm or oxygen saturation < 90%, with none requiring naloxone for reversal of OIRD.
- The most commonly occurring medical comorbidities in the elderly and obese patient groups included sleep apnea, diabetes, and hypertension, which are also known to increase the risk of OIRD.
“With this publication, we continue to add to the robust collection of peer-reviewed literature for OLINVYK that is available to clinicians,” said Mark Demitrack, M.D., Senior Vice President and Chief Medical Officer of Trevena, Inc. “Physicians still need to be mindful that life-threatening respiratory depression from opioids is more likely to occur in elderly patients. Physicians should monitor them closely, particularly when initiating and titrating OLINVYK and when OLINVYK is given concomitantly with other drugs that depress respiration.”
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