July 10, 2018

New Opioid in Development May Offer Reduced Risk Profile

Korsuva (formerly known as CR845) is a new opioid currently in development from Cara Therapeutics, but unlike most opioids, Korsuva acts on kappa opioid receptors in the brain, instead of mu receptors.

It is theorized that acting on kappa receptors can provide pain relief without causing central nervous system (CNS) effects typically associated with opioid use, such as abuse, addiction, euphoria, nausea, vomiting, sedation, or respiratory depression.

Human abuse liability studies support the view the Korsuva is unlikely to be recreationally abused or lead to physical dependence, and reports from Phase 2/3 clinical trials of IV-administered Korsuva showed significant pain reduction compared to placebo, along with a significant reduction in nausea and vomiting. The randomized, double-blind placebo-controlled trial included 444 patients undergoing abdominal surgery, testing doses at 1.0 mcg/kg and 0.5 mcg/kg. The 1.0 mcg/kg dose demonstrated greater analgesia, with a 73% reduction in vomiting.

Korsuva has demonstrated enough potential that it was granted Breakthrough Therapy designation from the FDA, meaning it will receive expedited review. If approved, Korsuva would be the first kappa opioid receptor agonist (KORA) available to treat pain.

While results thus far are positive, continued development of new opioids begs the question: is the answer to the opioid epidemic really more opioids? Healthesystems previously explored this question in “Future Opioids and the Injured Worker: Why ‘Safer’ Is a Relative Term.

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