Researchers point to ‘quantum leap’ in developing drugs to help combat opioid epidemic
David Crow in New York, March 20th, 2017
A US biotech company claims to have discovered a new opioid that can treat pain symptoms without generating the euphoric feeling that has fuelled America’s addiction crisis.A US biotech company claims to have discovered a new opioid that can treat pain symptoms without generating the euphoric feeling that has fuelled America’s addiction crisis.
Nektar Therapeutics, based in San Francisco, says the drug has a novel chemical structure which means it crosses the blood-brain barrier more slowly than traditional opioids such as Purdue Pharma’s OxyContin, also known as “hillbilly heroin” for its highly addictive properties. Drugmakers are racing to come up with a new generation of painkillers amid a US opioid addiction crisis that has been described as a national epidemic by the authorities, with 91 people dying each day by overdosing on the drugs, according to the Centers for Disease Control and Prevention. More Americans now die from drug overdoses than from car crashes or gun violence, and more than 26m are being treated for addiction, according to CDC figures. “We think we’ve made a huge quantum leap forward,” said Stephen Doberstein, chief scientific officer at Nektar. “It’s a fundamentally different approach that separates the analgesic efficacy from the addictive side effects.” Nektar shares shot up nearly 30 per cent on the back of the announcement and were trading at $19.98 at lunchtime in New York.
Many of the bigger, diversified pharma companies have either steered clear of opioids or scaled back their operations in recent years. But a handful of companies rely heavily on sales of opioid painkillers, including Depomed and Purdue. Others, such as Endo Pharmaceuticals and Mallinckrodt, generate a large chunk of their revenue from the pills. Nektar on Monday released the results of a large clinical trial of its drug, codenamed NKTR-181, which showed the medicine was as effective as traditional opioids at treating chronic back pain. Patient pain scores dropped by an average of 65 per cent during one part of the study.
A separate study into the abuse potential of NKTR-181 showed that patients taking the recommended dose reported significantly lower “drug liking” scores than for OxyContin, because the drug acted more slowly on the central nervous system. Mr Doberstein said the company was conducting another trial to determine whether patients would become high or euphoric if they took significantly more than the recommended maximum dose of 400mg. However, some doctors have argued that the US needs to dramatically reduce the number of opioids that are prescribed to patients rather than allowing pharmaceutical companies to launch new versions of the medicines.
Dr Andrew Kolodny, co-director of opioid research at the Schneider Institutes for Health Policy, said the problem with prescribing an opioid for a chronic condition such as lower back pain was that the drugs were “simply not that effective — even if there is less euphoria”. Dr Kolodny warned patients could still become “physiologically dependent” on opioids even if they did not experience a buzz, and said they might need to take increasingly higher doses of the medicine to achieve the same reduction in pain. “Among the leading experts in the country who study back pain the consensus is ‘don’t give opioids,’” he said. “Not simply because of the fear of addiction, but because they are not effective if taken for a long time and can even make the pain worse.” “It’s not like we don’t have other good options,” he added, listing alternatives such as ibuprofen and non-pharmaceutical interventions including physical therapy and weight loss. The city of Everett, Washington, recently said it would sue Purdue for its alleged role in fueling the area’s opioid crisis, while the state of West Virginia has filed lawsuits against companies who distributed or prescribed the medicines, such as Walgreens and CVS.