by Pradeep Chopra, MD for the RSDSA blog. Edited for clarity.
There is a lot of discussion about the newest medicine on the market.
Suzetrigine, marketed under the brand name Journavx, is a novel non-opioid analgesic recently approved by the U.S. Food and Drug Administration (FDA) for the treatment of moderate-to-severe acute pain in adults. Developed by Vertex Pharmaceuticals, it represents the first new class of pain medication approved in over two decades.
It works by blocking NaV1.8 channels. Pain is transmitted along nerves by the opening of NaV1.8 channels. Journavx blocks these sodium channels (NaV1.8) hence blocking pain transmission.
A few key points:
- It affects only the nerves at the periphery (outside of the brain and spinal cord) like your arms, legs, etc. It does not cause addiction.
- Unfortunately, Journavx is weaker than Vicodin in terms of controlling pain. It is more useful in acute post-operative pain and not in chronic pain. It failed treatment of low back pain.
- Given its weak nature, it is unlikely to help CRPS.
- CRPS is caused by central sensitization (aka pain triggered in the brain and spinal cord). Journavx does not act there.
Clinical Efficacy
The efficacy of Journavx was demonstrated in two randomized, double-blind, placebo- and active-controlled trials involving patients undergoing abdominoplasty and bunionectomy surgeries. In both studies, participants receiving Journavx reported a statistically significant reduction in pain compared to those receiving a placebo. While Journavx did not outperform the opioid combination of hydrocodone and acetaminophen (Vicodin), it provided effective pain relief without the associated risks of opioid use.
Benefits
- Non-Opioid Alternative: Journavx offers a new option for acute pain management, addressing the need for effective treatments without the addiction potential inherent to opioids.
- Targeted Mechanism: By selectively inhibiting the NaV1.8 sodium channel, Journavx specifically modulates pain signals in peripheral neurons, potentially leading to fewer central nervous system side effects.
Risks and Adverse Effects
In clinical trials, the most commonly reported adverse reactions among participants treated with Journavx included:
- Itching
- Muscle spasms
- Elevated blood levels of creatine phosphokinase
- Rash
Journavx is contraindicated for use with strong CYP3A inhibitors, and patients are advised to avoid consuming grapefruit products during treatment due to potential drug interactions.
Considerations
While Journavx has shown promise in managing acute pain, its efficacy in chronic pain conditions remains under investigation. A Phase 2 study focusing on lumbosacral radiculopathy (lower back pain) did not demonstrate a significant benefit over placebo, highlighting the challenges in treating chronic pain and the need for further research.
In summary, Journavx is not very impressive. It has a weak pain killing strength and is effective only in acute surgical pain and not for chronic pain. As with any medication, it is essential to weigh its benefits against potential risks and to consider individual patient needs when determining the most appropriate pain management strategy.
References
1. Oliver B, Devitt C, Park G, Razak A, Liu SM, Bergese SD. Drugs in Development to Manage Acute Pain. Drugs. 2025 Jan;85(1):11-19. doi: 10.1007/s40265-024-02118-0. Epub 2024 Nov 19. PMID: 39560856.
2. Hang Kong AY, Tan HS, Habib AS. VX-548 in the treatment of acute pain. Pain Manag. 2024 Sep;14(9):477-486. doi: 10.1080/17581869.2024.2421749. Epub 2024 Nov 18. PMID: 39552600; PMCID: PMC11721852.
Copyright 2025 Pradeep Chopra. All rights reserved.