Opioid Analgesics Market: Competitive Landscape, Pipeline, and Market Analysis, 2022

Opioids (Narcotic analgesics) are a class of medicines that are used to provide relief from moderate-to-severe acute or chronic pain. Opioids act both presynaptically and postsynaptically to produce an analgesic effect. Presynaptically, opioids block calcium channels in nociceptive afferent nerves to inhibit the release of neurotransmitters such as the substance P and glutamate, which contribute to nociception. Postsynaptically, opioids open potassium channels, which hyperpolarizes cell membranes, increasing the required action potential to generate nociceptive transmission. The mu, kappa, and delta-opioid receptors mediate analgesia spinally and supraspinally. Opioids can be used in hospital settings to relieve pain from myocardial infarction, sickle cell crisis, pain associated with pre-and postoperative surgical conditions, trauma, severe chronic pain in cancer, pain from kidney stones, and severe back pain. Purdue Pharma, J&J Services, Hikma Pharmaceuticals, Pfizer, AbbVie, Sanofi, and Sun Pharmaceuticals are some of the key players in the opioid analgesics market.

Key Developments

• In Aug 2019, Pernix Therapeutics’s Zohydro ER (Hydrocodone bitartrate extended release) was evaluated for the relative intranasal abuse potential. Incidences of adverse events for intranasal treatments were 52% for hydrocodone ER, 53% for hydrocodone powder, and 61% for HYD-OF. The statistically significant differences between hydrocodone ER vs hydrocodone powder and HYD-OF for the primary drug-liking endpoints indicate a lower intranasal abuse potential with hydrocodone ER in healthy, non-dependent, and recreational opioid users.
• In Oct 2020, Insys Therapeutics’s Subsys (Fentanyl sublingual spray) upon given prophylactically was well tolerated and demonstrated a dose-response relationship in improving both dyspnea and walk distance.
• In May 2023, Tris Pharma’s Cebranopadol (TRN-228), a mixed NOP/opioid receptor agonist with full efficacy at NOP and MOP receptors, produces robust analgesic efficacy with reduced adverse effects, conferring promising outcomes in clinical studies.

Approved Opioid Analgesics

• ABSTRAL (Fentanyl sublingual tablets)
• DILAUDID (Hydromorphone)
• STADOL (Butorphanol)
• DEMEROL (Meperidine)
• ZOHYDRO ER (Hydrocodone)
• NUBAIN (Nalbuphine)
• DOLOPHINE (Methadone)
• DARVON (Propoxyphene)
• TALWIN (Pentazocine)
• DURAGESIC (Fentanyl)
• ZUBSOLV (Buprenorphine and Naloxone)
• OLINVYK (Oliceridine)
• OXECTA (Oxycodone HCl)
• ULTRACET (Acetominophen and Tramadol HCl)
• OXYCONTIN (Oxycodone HCl)
• BELBUCA (Buprenorphine)
• TROXYCA ER (Oxycodone+ Naltrexone)
• AVINZA (Morphine sulphate)
• SUBSYS (Fentanyl Sublingual Spray)
• NUCYNTA (Tapentadol)
• DSUVIA (Sufentanil)
• TIVORBEX (Indomethacin)
• TARGINIQ ER (Oxycodone HCl + Naloxone HCl)
• LAZANDA (Fentanyl citrate)
• BUTRANS (Buprenorphine)
• SPRIX (Ketorolac tromethamine)
• QUADRAMET (Samarium Sm 153 Lexidronam Injection)

Drugs under the Pipeline for Opioid Analgesics

• TRN-228 (Cebranopadol)
• JNS020QD (Fentanyl)
• GRT9906 PR
• OX27

Clinical Activity and Development of Opioid Analgesics

Currently, there are more than 25 drug products in the opioid analgesic segment in the market. Moreover, about 20 pharmaceutical companies have their products in the pipeline for studying new indications of opioid analgesics.

• In Dec 2020, J&J’s Ultracet (Tramadol HCl/Acetaminophen ER), according to multiple reports, it was observed that epidural tramadol can provide prolonged postoperative analgesia, without early and delayed clinical respiratory depression. Some studies suggest that caudal epidural tramadol is more efficacious and provides longer-lasting analgesia postoperatively in comparison to intravenous tramadol.
• In Aug 2022, AcelRx Pharmaceuticals’s Dsuvia (Sufentanil sublingual tablets) appeared to be an effective alternative analgesic therapy in spine surgery patients who experience moderate to severe postoperative pain, resulting in improved pain scores in the postoperative recovery period.
• In Apr 2023, Endo International’s Ryzolt (abuse resistant formulation), in a combination study with comparison between tramadol/acetominophen (TT group) and acetominophen (AA group), tramadol appeared to be able to effectively relieve pain, shorten the onset of sensory block, prolong the duration of sensory block, and achieve the lowest consumption of pethidine. 
  
  
  

  Molecule Name	Number of Studies
  TRN-228 (Cebranopadol)	13
  JNS020QD (Fentanyl)	1
  GRT9906 PR	3
  OX27	1