FDA ap­proves first non-opi­oid to treat with­draw­al symp­toms in adults

The opi­oid ad­dic­tion mar­ket got a new play­er Wednes­day with the FDA ap­proval of Luce­myra, a pill that helps pa­tients man­age symp­toms of with­draw­al.

The drug, which has been used in the Unit­ed King­dom for more than two decades now, is made by Louisville, KY-based US WorldMeds. The spe­cial­ty phar­ma was not grant­ed ap­proval to treat opi­oid use dis­or­der, but in­stead to treat symp­toms of with­draw­al.

Scott Got­tlieb

For those ad­dict­ed to opi­oids, quit­ting cold turkey can be a har­row­ing ex­pe­ri­ence. In as lit­tle as a few hours, pa­tients may ex­pe­ri­ence stom­ach cramps, mus­cle aches and spasms, a pound­ing heart, nau­sea, vom­it­ing and di­ar­rhea. Oth­er symp­toms in­clude anx­i­ety, ag­i­ta­tion, de­pres­sion and in­som­nia.

The NIH says these symp­toms aren’t di­rect­ly life-threat­en­ing, but they can dri­ve the pa­tient back to opi­oid use — of­ten over­dos­ing af­ter ex­pe­ri­enc­ing with­draw­al.

“We know that the phys­i­cal symp­toms of opi­oid with­draw­al can be one of the biggest bar­ri­ers for pa­tients seek­ing help and ul­ti­mate­ly over­com­ing ad­dic­tion,” said FDA com­mis­sion­er Scott Got­tlieb in a state­ment. “The fear of ex­pe­ri­enc­ing with­draw­al symp­toms of­ten pre­vents those suf­fer­ing from opi­oid ad­dic­tion from seek­ing help. And those who seek as­sis­tance may re­lapse due to con­tin­ued with­draw­al symp­toms.”

Sharon Hertz

Luce­myra (lofex­i­dine hy­drochlo­ride) was orig­i­nal­ly in­tend­ed to be a hy­per­ten­sion drug. It re­duces the re­lease of nor­ep­i­neph­rine, a hor­mone be­lieved to play a key role in trig­ger­ing with­draw­al symp­toms. In two ran­dom­ized, dou­ble-blind, place­bo-con­trolled tri­als, 866 adult pa­tients demon­strat­ed the ben­e­fits and safe­ty of the drug. Com­pared to the place­bo group, pa­tients treat­ed with Luce­myra re­port­ed a low­er sever­i­ty of symp­toms. Plus, pa­tients who got Luce­myra were more like­ly to com­plete the course of treat­ment, which can on­ly last for up to 14 days.

The FDA is re­quir­ing 15 ad­di­tion­al stud­ies to fur­ther as­sess the drug’s safe­ty when used in chil­dren, for longer than 14 days, and in oth­er sit­u­a­tions that were not test­ed in the ear­li­er tri­als.

It will be in­ter­est­ing to see whether a drug like Luce­myra com­petes or is used in tan­dem with drugs like Sublo­cade, the in­jectable ver­sion of In­di­v­ior’s pop­u­lar opi­oid use dis­or­der drug Sub­ox­one. Sublo­cade, a month­ly in­jec­tion of buprenor­phine, con­tains a mild opi­oid to help stymie with­draw­al symp­toms for ad­dicts quit­ting opi­oid use.

Sublo­cade is ap­proved to treat opi­oid abuse dis­or­der, but it al­so con­tains opi­oids itelf. Some pa­tients — or doc­tors — may pre­fer an op­tion like Luce­myra to ease with­draw­al symp­toms, as it the drug does not con­tain opi­oids.

“To­day’s ap­proval rep­re­sents the first FDA-ap­proved non-opi­oid treat­ment for the man­age­ment of opi­oid with­draw­al symp­toms and pro­vides a new op­tion that al­lows providers to work with pa­tients to se­lect the treat­ment best suit­ed to an in­di­vid­ual’s needs,” said Sharon Hertz, di­rec­tor of the Di­vi­sion of Anes­the­sia, Anal­ge­sia and Ad­dic­tion Prod­ucts at the FDA.

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Despite rapid advances in the field of immuno-oncology that have transformed the cancer treatment landscape, many cancer patients are still left behind.1,2 Not every person has access to innovative therapies designed specifically to treat his or her disease. Many currently available immuno-oncology-based approaches and chemotherapies have brought long-term benefits to some patients — but many patients still need other therapeutic options.3

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