Oliceridine for the Management of Acute Postoperative Pain

Abstract

Objective To review the pharmacological characteristics, clinical evidence, and place in the management of acute postoperative pain severe enough to require an intravenous opioid. Data Sources A comprehensive literature search was conducted in PubMed (January 2000 to December 1, 2020). Key search terms included oliceridine or acute postoperative pain. Other sources were derived from product labeling and ClinicalTrials.gov. Study Selection and Data Extraction All English-language articles identified from the data sources were reviewed and evaluated. Phase I, II, and III clinical trials were included. Data Synthesis Oliceridine is a novel selective µ-receptor G-protein pathway modulator. It has the property of activating G-protein signaling while causing low β-arrestin recruitment to the µ-receptor. Intravenous oliceridine showed statistically superior analgesia than placebo in patients with moderate or severe pain after surgery, with a favorable safety and tolerability profile regarding respiratory and gastrointestinal adverse effects, compared with morphine. Relevance to Patient Care and Clinical Practice The analgesic capacity of oliceridine is at least comparable to that of morphine at clinically relevant dosages, with a rapid onset of action. Also, it may be associated with a lower incidence of adverse events at dosing regimens associated with comparable analgesia. These data suggest that oliceridine may provide an important new treatment option for the management of moderate to severe postoperative pain where an intravenous opioid is warranted. Conclusion Oliceridine has obvious analgesic effects in patients with moderate or severe pain after surgery; additionally, it has a favorable safety and tolerability profile.

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

“…While myriad multimodal strategies exist, ongoing comparative assessments of analgesic combinations and anesthetic approaches within enhanced recovery practice are warranted to further understand and optimize perioperative patient care. Novel analgesic agents and modalities continue to be developed, and their place in therapy should be thoughtfully studied [56,286,[533][534][535][536]. Pharmacogenomic assessments show promise in elucidating precision pain management [537,538].…”

Biased Agonism: Lessons from Studies of Opioid Receptor Agonists

“…The consequences of classifying novel ligands as biased without either numerical justification of statistically significant bias or corroboration of bias data from different studies are now becoming evident in areas beyond the confines of in vitro cell signaling and in vivo animal studies. In the clinical literature there is continuing reference to these new μ-opioid receptor agonists as being advantageous to the patient on the basis of their G protein bias, thus implying to the medical community mechanisms of drug action, such as G protein bias, that may not be justified at this time (99)(100)(101)(102)(103). Therefore, a careful assessment is needed of where we are in terms of biased ligands at the μ-opioid receptor.…”