Acute Pain2026-07-11

Acute Pain Drug Development Landscape: The Era of Non-Addictive Pain Meds

Vertex Pharma ended a 25-year innovation drought in 2025 with suzetrigine, their non-opioid acute pain therapy. Here is what the rest of the acute pain treatment pipeline looks like.

Journavx's Approval

Vertex Pharma's innovation has led to a new option for non-opioid, non-addictive acute pain management for the first time in a quarter century.^[1] Suzetrigine (brand name Journavx) was approved by the FDA in early 2025 as a first in class non-opioid analgesic used to treat moderate to severe acute pain.^[2]

Suzetrigine is a selective NaV1.8 sodium channel inhibitor, blocking pain signals at peripheral nerves as opposed to modulating brain activity.^[1] The drug received FDA approval based on data from three distinct phase 3 trials.^[3] These trials assessed acute pain management for both post-operative pain as well as non-surgical pain. Based on accepted standards for evaluating pain management therapies in a post-operative setting, the trials assessed the use of suzetrigine after abdominoplasty (soft-tissue pain) and bunionectomy (hard-tissue pain).^[4]

In the abdominoplasty trial, participants achieved on average a 48.4 point greater reduction in pain compared to placebo on the SPID48 scale (i.e., time weighted scale of 0-10 pain rankings for 48 hours after first dose).^[5] The post-bunionectomy trial captured 29.3 points greater in pain relief on SPID48 (both results statistically significant). Vertex's third, single-arm trial on the other hand assessed the portion of participants that reported good, very good, or excellent pain relief in their assessment, which was true for 83.2% of participants.^[6]

Overall suzetrigine presented meaningful improvements in acute pain management and fewer side effects compared to hydrocodone bitartrate/acetaminophen (i.e., commonly used opioid pain medication), all through multiple phase 3 trials spanning post-surgical and non-surgical acute pain events.^[5] Despite FDA approval, perspectives on Journavx's clinical outcomes are not all positive; US ICER's health economic assessment of the therapy presented mixed panelist outcomes on the net clinical benefit and cost-effectiveness of the therapy.^[7]

Journavx Commercial Outcomes

Journavx's launch in January of 2025 meant the year would be a ramp up for mass market uptake and adoption, with at least 3-7 more years until peak annual revenue is achieved. Pharmacy availability of the drug kicked off in March, leading to 550,000 prescriptions of the therapy in Q2-Q4 of 2025 and $59.6 million in revenue.^[8] Q1 2026 revenue amounted to $29 million, showcasing an annualized increase.^[9]

Novel Therapeutic Strategies

Following in Journavx's footsteps, numerous novel therapies are being developed for acute pain treatment. While there are numerous therapeutic strategies for targeting acute pain, the majority of assets in the pipeline fall into two distinct categories:

Voltage Gated Sodium Channel Blockers: NaV 1.7, 1.8, and 1.9 sodium channels are all being targeted selectively, with NaV1.8 inhibition most common, following the lead of Journavx's FDA approval.^[10] This is by far the most popular strategy for novel therapeutics targeting acute pain, with 6 of the 14 pipeline assets leveraging sodium channel blocking. Most assets in this category are small molecules.
Opioid receptor agonists (MOR, KOR, NOR): Opioid receptor targeting is the traditional therapeutic approach for pain relief. However, specific opioid receptors, namely KOR and NOR, are thought to exhibit fewer negative side effects and less addictive potential than traditional opioid medications.^[11]^[12] 4 pipeline assets fall into this category.

There are additional therapeutic strategies each with only one asset in the pipeline, representing less of a broader trend in acute pain drug development and more so one-off bets:

Dual COX Inhibitors & Voltage-Gated Calcium Channel Modulators: COX inhibition is the mechanism that traditional NSAID therapies utilize. A novel asset is looking to combine that mechanism with calcium channel modulation, which has been linked to potential benefits in pain reduction (albeit more closely tied to chronic pain).^[13]
Cytoskeletal Remodeling Inhibitors: This approach targets pain-sensing neurons by docking onto surface ganglioside GT1b, where the therapy enzymatically locks G-actin to prevent the formation of structural actin chains. By permanently disrupting this essential cytoskeletal remodeling, the drug halts the transmission of pain action potentials to act as a highly targeted, long-lasting molecular nerve block.^[14]
Voltage Gated Potassium Channel Openers: Opposite to sodium channel blocking, KV7 potassium channel opening also has therapeutic potential for pain relief.^[15] There is only one pipeline asset listed that follows this approach, as potassium channel modulation is linked more to chronic pain relief.^[16] This asset is in phase 1 and has a broad "pain" indication label, meaning it likely is targeting chronic pain as opposed to acute.

Acute Pain Pipeline Overview

Below is a summary of assets in the acute pain drug development pipeline:

Drug Name	MOA	ROA	Sponsor	Sponsor Country	Phase
Suzetrigine	Small molecule NaV1.8 sodium channel inhibitor	Oral	Vertex Pharma	US	Phase 4 (approved)
Cebranopadol	Dual NOP/MOP receptor (dual-NMR) agonist	Oral (potential intranasal)	Tris Pharma	US	Phase 3
XG005	Dual COX inhibitor / peripheral α2δ calcium channel modulator	Oral	Xgene Pharma	China	Phase 3 (expected)
TRN-261	Peptide molecule; MOA undisclosed	Undisclosed (likely IV or Sub-Q)	Tris Pharma	US	Phase 2 (expected)
LTG-001	Small molecule NaV1.8 sodium channel inhibitor	Oral	Latigo Biotherapeutics	US	Phase 2 (recently completed)
LY4515100	Small molecule NaV1.8 sodium channel inhibitor	Oral	Eli Lilly	US	Phase 2
N-001	Peptide binding ganglioside GT1b; disrupts G-actin cytoskeletal remodeling	Injection (intramuscular)	Neurocarrus	US	Pre-clinical
XEN1701	NaV1.7 sodium channel inhibitor	Undisclosed (likely oral)	Xenon Pharma	Canada	Phase 1
XEN1120	KV7 potassium channel opener	Undisclosed (likely oral)	Xenon Pharma	Canada	Phase 1
HSK55718	Small molecule NaV1.8 sodium channel blocker	IV	AbbVie, Haisco Pharmaceutical Group	US, China	Phase 2
Undisclosed Asset	NaV1.7, 1.8, or 1.9 sodium channel blocker	Undisclosed	Nocion Therapeutics	US	Pre-clinical
Tegileridine^*	Small molecule mu-opioid receptor biased agonist	IV	Jiangsu Hengrui Medicine	China	Market approved (China)
Susineridine^*	Small molecule, G protein-biased mu-opioid receptor agonist (MOR)	IV	Shanghai Haiyan Pharmaceutical Technology	China	Phase 3 (China)
Anrikefon^*	Short-chain polypeptide, kappa opioid receptor agonist	IV	Haisco Pharmaceutical Group	China	Approved (China)

^* These assets are developed exclusively for China and do not have any current indications of expanding to other markets.

Pipeline Coverage Disclaimer: While this report is intended to be comprehensive of the global acute pain drug development pipeline, it does not cover every asset. Highest coverage priority is on assets in later stages of clinical development. Assets in preclinical and discovery stages are also included to the extent possible, but were deprioritized as they are less currently consequential to the acute pain treatment landscape. There is also a smaller digital footprint for these earlier stage assets, with some companies not disclosing any specifics, or not yet outlining whether acute pain or chornic pain is their first target indication. Lastly, assets from Chinese biotechs have much smaller digital footprints and may not all have been captured.

Acute Pain Pipeline Deep Dive

1. Suzetrigine (Vertex Pharma)

Name(s)	Suzetrigine, JOURNAVX
Molecule Type / MOA / Therapeutic Strategy	Small molecule NaV1.8 voltage-gated sodium channel inhibitor^[17]
ROA	Oral
Target Indication(s)	Moderate to Severe Acute Pain^[2]
Sponsor	Vertex Pharma
Sponsor Country	US
Trial Phase	Phase 4 (i.e., already approved; pursuing expansion into chronic pain indications)
Trial Name / NCT ID	Multiple phase 3 trials supported approval in acute pain. NCT05558410^[18] NCT05553366^[19] NCT05661734^[20]

Trial Progress, Data Readouts, Next Milestones

Multiple phase 3 trials for specific acute pain conditions are being conducted to generate additional supporting clinical data on Journavx's efficacy.^[21]

Indication expansion into chronic pain is also ongoing, with Vertex targeting Diabetic Peripheral Neuropathy (DPN) and Chronic Painful Lumbosacral Radiculopathy (PLSR) in phase 3 and phase 2 trials respectively.

DPN: NCT06696443^[22], NCT07231419^[23], NCT06628908^[24]

PLSR: NCT06176196^[25]

Related Pipeline Assets

Vertex has additional sodium channel blockers in its pipeline, namely NaV1.7 inhibitors in preclinical stages of development.^[26]

2. Cebranopadol (Tris Pharma)

Name(s)	Cebranopadol, TRN-228
Molecule Type / MOA / Therapeutic Strategy	Dual nociceptin/orphanin FQ peptide (NOP) receptor and mu-opioid peptide (MOP) receptor agonist
ROA	Oral, with potential for intranasal administration^[27]
Target Indication(s)	Moderate to Severe Acute Pain
Sponsor	Tris Pharma
Sponsor Country	US
Trial Phase	Phase 3
Trial Name / NCT ID	Two phase 3 trials, one for post-operative soft-tissue and one for hard-tissue acute pain. ALLEVIATE1: NCT06545097^[28] ALLEVIATE2: NCT06423703^[29]

Trial Progress, Data Readouts, Next Milestones

Initial data from both trials was announced in March 2026, with lower pain scores for participants receiving cebranopadol vs placebo in both trials.^[30]

Related Pipeline Assets

See entry below for Tris Pharma's other asset in phase 2.

3. XG005 (XGene Pharma)

Name(s)	XG005
Molecule Type / MOA / Therapeutic Strategy	Dual-targeting cyclooxygenase (COX) inhibitor and peripheral α2δ calcium channel modulator^[31]^[32]
ROA	Oral
Target Indication(s)	Acute Pain
Sponsor	Xgene Pharma
Sponsor Country	China
Trial Phase	Phase 3 (expected)
Trial Name / NCT ID	Not yet available

Trial Progress, Data Readouts, Next Milestones

The most recent data comes from a phase 2/3 trial that wrapped up in late 2024; the primary endpoint measured summed pain intensity (SPI) over 48 hours post-surgery, in which XG005 demonstrated a 53.6% reduction vs placebo.^[33]

The therapy has not yet kicked off its expected phase 3 trial.^[34] The most recent update on the trial came from Xgene Pharma's newsroom last year in July 2025, stating that the phase 3 US-based trial was expected to begin in 2025.^[35] There are no indications however of such a trial being registered or kicking off.^[36]

Related Pipeline Assets

Xgene has two discovery stage assets in their pipeline, XG045 and XG046. Both are also dual mechanism therapies and are listed as "patent pending."^[32]

4. TRN-261 (Tris Pharma)

Name(s)	TRN-261
Molecule Type / MOA / Therapeutic Strategy	Peptide molecule with undisclosed MOA^[37]
ROA	Undisclosed (likely either IV or Sub-Q)
Target Indication(s)	Pain (currently targeting both acute and chronic pain indications)^[37]
Sponsor	Tris Pharma
Sponsor Country	US
Trial Phase	Phase 2 (expected)
Trial Name / NCT ID	NA

Trial Progress, Data Readouts, Next Milestones

There is no registration or announcement of kickoff for the phase 2 trial. TRN-261 was acquired by Tris Pharma after it had gone through extensive safety studies in non-pain indications.

Related Pipeline Assets

See entry above for Tris Pharma's other asset in phase 3.

5. LTG-001 (Latigo Biotherapeutics)

Name(s)	LTG-001
Molecule Type / MOA / Therapeutic Strategy	Small molecule NaV1.8 sodium channel inhibitor^[38]
ROA	Oral
Target Indication(s)	Acute pain
Sponsor	Latigo Biotherapeutics
Sponsor Country	US
Trial Phase	Phase 2 (recently completed)
Trial Name / NCT ID	Soft-tissue pain trial: NCT07102459^[39] Hard-tissue pain trial: NCT06774625^[40]

Trial Progress, Data Readouts, Next Milestones

Both phase 2 trials have recently wrapped up, with data readouts likely to be published soon. There isn't yet a phase 3 trial announcement. However, Latigo Bio's three most recent media updates were appointments of board of director members and a CFO/CBO.^[41] The biotech also raised a $150 million series B in March of 2025. All of this is likely continued efforts to get the necessary funding and leadership in place to conduct a phase 3 trial for their lead asset LTG-001.

LTG-001 was also granted FDA Fast Track Designation in March 2025.^[42]

Related Pipeline Assets

Latigo Bio has three other assets in their pain-centric development pipeline.^[38] LTG-305 is another NaV1.8 sodium channel inhibitor that completed its phase 1 trial in June 2025.^[43] No phase 2 announcements have been made and are likely also pending financial and leadership changes necessary to continue developing the asset.

Two additional undisclosed assets are in preclinical and discovery stages of development: the former a NaV1.8 sodium channel inhibitor, the latter an Acid Sensing Ion Channel (ASIC) inhibitor.

6. LY4515100 (Eli Lilly)

Name(s)	LY4515100, STC-004
Molecule Type / MOA / Therapeutic Strategy	Small molecule NaV1.8 sodium channel inhibitor^[44]
ROA	Oral
Target Indication(s)	Acute pain (also pursuing chronic pain)
Sponsor	Eli Lilly
Sponsor Country	US
Trial Phase	Phase 2
Trial Name / NCT ID	NCT07339722^[45]

Trial Progress, Data Readouts, Next Milestones

While the trial end date estimate by clinicaltrials.gov is midyear 2026, Eli Lilly indicates the trial could last until December 2026.^[46] LY4515100 is being assessed for pain relief in a hard tissue model (third molar removal) and will likely enter additional phase 2 / 3 trials that also include soft-tissue pain relief.^[45]

Related Pipeline Assets

Through its acquisition of SiteOne Therapeutics, Lilly also gained ownership of an asset designed for NaV1.7 sodium channel inhibition. It seems this asset however is no longer being pursued as the phase 1 trial for the therapy was terminated^[47] and is nowhere to be found in Lilly's pipeline.

Lilly's other pipeline assets (LY4065967 and LY3848575 / Turigrobart (Epiregulin Ab)) are also in phase 2 but are focused on chronic pain indications.^[44]

7. N-001 (Neurocarrus)

Name(s)	N-001
Molecule Type / MOA / Therapeutic Strategy	Peptide that binds to ganglioside GT1b and enables ADP-ribosylation of G-actin, reducing actin remodeling^[14]
ROA	Injection (likely intramuscular)^[14]
Target Indication(s)	Pain (too early in development for specific subtyping)^[48]
Sponsor	Neurocarrus
Sponsor Country	US
Trial Phase	Pre-clinical
Trial Name / NCT ID	NA

Trial Progress, Data Readouts, Next Milestones

The most recent update on the therapy was a 2023 publication of preclinical in vivo mouse model results.^[14] No announcements have been made since.

Related Pipeline Assets

Neurocarrus has assets for migraine and chronic pain, but none that may also target acute pain.^[48]

8. XEN1701 (Xenon Pharma)

Name(s)	XEN1701
Molecule Type / MOA / Therapeutic Strategy	NaV1.7 Sodium Channel Inhibitor (molecule type undisclosed, likely a small molecule)^[49]^[50]
ROA	Undisclosed but likely oral given predicted small molecule modality
Target Indication(s)	Pain
Sponsor	Xenon Pharma
Sponsor Country	Canada
Trial Phase	Phase 1
Trial Name / NCT ID	Not available

Trial Progress, Data Readouts, Next Milestones

Phase 1 trial is expected to complete in H2 of 2026.^[51]

Related Pipeline Assets

See entry below for Xenon's other pain-targeting asset (XEN1120).

9. XEN1120 (Xenon Pharma)

Name(s)	XEN1120
Molecule Type / MOA / Therapeutic Strategy	KV7 Potassium Channel Opener (molecule type undisclosed, likely a small molecule)^[49]^[52]
ROA	Undisclosed but likely oral given predicted small molecule modality
Target Indication(s)	Pain
Sponsor	Xenon Pharma
Sponsor Country	Canada
Trial Phase	Phase 1
Trial Name / NCT ID	Not available

Trial Progress, Data Readouts, Next Milestones

Phase 1 trial is expected to complete in H2 of 2026.^[51]

Related Pipeline Assets

See entry above for Xenon's other pain-targeting asset (XEN1701).

10. HSK55718 (AbbVie)

Name(s)	HSK55718
Molecule Type / MOA / Therapeutic Strategy	Small molecule NaV1.8 sodium channel blocker
ROA	IV
Target Indication(s)	Acute Pain
Sponsor	AbbVie, Haisco Pharmaceutical Group (original developer)^[53]
Sponsor Country	US, China
Trial Phase	Phase 2
Trial Name / NCT ID	NCT07491146^[54]

Trial Progress, Data Readouts, Next Milestones

No data has read out yet as the phase 2 trial with sites exclusively in China is set to kick off in H1 2026.^[54] While there are no definitive indicators yet of ex-US commercialization, AbbVie's aquisition means they will likely run US and global phase 2-3 trials to pursue broader global markets.

Related Pipeline Assets

Haisco has another asset included in AbbVie's licensing deal. HSK51155 is also a NaV1.8 sodium channel blocker but an oral formulation compound in the preclinical stage.^[53]

11. Undisclosed Asset (Nocion Therapeutics)

Name(s)	NA
Molecule Type / MOA / Therapeutic Strategy	NaV1.7, 1.8, or 1.9 sodium channel blocker
ROA	Undisclosed
Target Indication(s)	Post-operative acute pain^[55]
Sponsor	Nocion Therapeutics
Sponsor Country	US
Trial Phase	Preclinical^[55]
Trial Name / NCT ID	NA

Trial Progress, Data Readouts, Next Milestones

Preclinical data was highlighted at the Non-Opioid Pain Therapeutics Summit in January 2026.^[56] Further details on the asset and clinical trial developments have not been announced. Nocion is likely more focused on their lead asset targeting chronic cough.^[57]

Related Pipeline Assets

Not yet disclosed, but Nocion likely has multiple assets that may be targeting an acute pain indication.^[56]

Assets with Current Development Focus Exclusively in China

12. Tegileridine (Jiangsu Hengrui Medicine)

Name(s)	Tegileridine, Aisute, SHR-8554
Molecule Type / MOA / Therapeutic Strategy	Small molecule mu-opioid receptor biased agonist^[58]
ROA	IV
Target Indication(s)	Acute Pain
Sponsor	Jiangsu Hengrui Medicine
Sponsor Country	China
Trial Phase	Market approved (in China)
Trial Name / NCT ID	NA

Trial Progress, Data Readouts, Next Milestones

Tegileridine received approval in China in 2024 based off of its phase 3 trial in moderate to severe acute pain following abdominal surgery.^[58]^[59] Additional trials are planned for the therapy but none seem to be global, indicating no clear intentions for pursuing ex-China expansion.^[60]

Related Pipeline Assets

Jiangsu Hengrui Medicine has additional assets in pipeline targeting acute pain.

HRS-2129 is a small molecule NaV1.8 sodium channel inhibitor currently undergoing a phase 2/3 trial in China.^[61]^[62]
HRS-6257 modality and MOA seem to be undisclosed but is targeting pain and is actively undergoing a phase 1 trial.^[63]

13. Susineridine (Shanghai Haiyan Pharmaceutical Technology)

Name(s)	Susineridine, YZJ-4729
Molecule Type / MOA / Therapeutic Strategy	Small molecule, G protein-biased mu-opioid receptor agonist (MOR) (avoids beta-arrestin2 signaling to minimize respiratory depression and constipation)^[64]
ROA	Intravenous
Target Indication(s)	Moderate to Severe Acute Pain
Sponsor	Shanghai Haiyan Pharmaceutical Technology
Sponsor Country	China
Trial Phase	Phase 3 (trial sites only in China, not global)
Trial Name / NCT ID	NCT06890533^[65]

Trial Progress, Data Readouts, Next Milestones

The trial is still in progress, with results likely to emerge soon as primary completion occurred in April 2026 and study completion is projected for September 2026.^[65]

Important to note that this phase 3 trial is set in China exclusively, meaning this drug would require further global phase 3 clinical trials in order to pursue FDA, EMA, or other ex-China market approvals. Effectively, ex-China market entry is not feasible for this therapy in the near term.

Related Pipeline Assets

None. The only other pain asset in trials from Shanghai Haiyan Pharma is YZJ-1495 in a phase 1b trial, but it's targeting chronic neuropathic pain.^[66]

14. Anrikefon (Haisco Pharmaceutical Group)

Name(s)	Anrikefon, HSK21542
Molecule Type / MOA / Therapeutic Strategy	Short-chain polypeptide, kappa opioid receptor agonist^[67]
ROA	IV
Target Indication(s)	Acute pain
Sponsor	Haisco Pharmaceutical Group
Sponsor Country	China
Trial Phase	Approved (in China)^[68]
Trial Name / NCT ID	NCT05390905^[69]

Trial Progress, Data Readouts, Next Milestones

The phase 3 trial has completed to gain approval in the Chinese market.^[70] No new trial announcements have been made for global phase 3 data collection to pursue approval in the US or other ex-China markets.

Related Pipeline Assets

Haisco's two other acute pain targeting assets were sold to AbbVie through a licensing agreement (see entries above).^[53]

Additional Pipeline Considerations: Assets with Unknown Development Statuses or Discontinuation

Below are additional therapies that are not serious contenders in the pipeline due to unknown development statuses, but are still worth noting.

1. Vocacapsaicin (Concentric Analgesics)

Developed by Concentric Analgesics, Vocacapsaicin (CA-008) is a TRPV1 agonist that has not had any clinical developments since 2021 and the company's most recent financing round was all the way back in 2022.^[71]^[72] This therapy is likely no longer in serious contention to enter the acute pain treatment landscape.

2. Otenaproxesul (Taro Pharmaceuticals)

A chemical derivative of naproxen (the active ingredient in over the counter pain relievers), Otenaproxesul has been modified to prevent the side effect of stomach ulcers.^[73] While promising data focused on demonstrating this safety benefit compared to existing NSAIDs emerged, no new development updates on this therapy have been released in the last 2 years.^[74] The drug developer's own website (Antibe Therapeutics) lists outdated trial updates for 2024, and the most recent news event is an FDA hold placed on the therapy's phase 2 trial in mid-2024.^[75]^[76] This therapy is not a novel mechanism of action for pain treatment and is likely not a relevant candidate for reshaping the acute pain treatment landscape.

3. NTM-006 (Neumentum)

Neumentum acquired rights to NTM-006 from J&J after a phase 2a trial against placebo and acetaminophen. While the therapy is still listed in Neumentum's pipeline, there have been no new trials or press releases on the asset since 2019 and 2021 respectively.^[77]^[78] It is quite likely that this asset has been abandoned in pursuit of an acute pain indication. The company also has two preclinical stage assets listed in their pain development pipeline, NTM-004 and NTM-005. These assets also do not have any recent development updates.

4. ODM-11 (Orion Pharma)

Orion had acquired ODM-11 (formerly JMKX000623) from the Chinese Biotech Jemincare in 2022 to develop the NaV1.8 Sodium Channel blocker pain treatment.^[79] The molecule is absent from Orion's pipeline and is likely discontinued, as its phase 2 trial in the EU was terminated early in 2024 due to safety concerns.^[80]^[81] The trial seemed to have been focused on chronic pain rather than acute, but it's a moot point given the therapy will likely not be further developed for either pain indication.

5. FZ002 (Guangzhou Fermion Technology)

FZ002 is an oral, small molecule, SSTR4 agonist targeting both chronic and acute pain.^[82]^[83] While the therapy was announced to be phase 2-ready, no press releases have surfaced since January 2025 indicating phase 2 planning / kickoff.^[82] They also have an asset FZ008 listed, a preclinical program targeting acute and chronic pain.^[83]

6. Unnamed TRPA1 Antagonist (Algomedix)

Algomedix lists a TRPA1 antagonist in their pipeline at the preclinical development stage.^[84] There are however no updates on their newsfeed or elsewhere on further developments with this asset.

Additional Pipeline Considerations: Reformulations of Existing Molecules

There are also a number of therapies which are pursuing incremental innovations through reformulations of existing compounds. While this report is focused on innovative new biology and novel therapeutic approaches, some of the major reformulation drug programs are listed below since they may be a relevant part of the future treatment landscape / healthcare spend on acute pain treatment.

Therapy	Sponsor	Strategy
NTM-001	Neumentum	Premixed bag of the traditional NSAID ketorolac for continuous infusion.^[85]
ATX-101	Allay Tx	Combining existing generic local anesthetic bupivacaine with a slowly dissolving bioabsorbable polymer.^[86]
CPL-1	Cali Biosciences	Sustained-release formulation of the local anesthetic ropivacaine.^[87]
MR-107A-02	Viatris	Fast acting formulation of the existing NSAID meloxicam.^[88]
LC-400	Lipocure	Slow release hydrogel formulation of the local anesthetic bupivacaine.^[89]

Concluding Remarks

Relative to most other drug development pipelines that we have reviewed at Inflection Bio, the acute pain treatment pipeline is riddled with asset programs that are struggling much more to stay on a continuous path of development.

Many assets appear to stall after phase 1 and 2 trials, with no trace of updates or future trial announcements in the last 3-5 years. In some cases this may be due to underwhelming outcomes from the trials. In others it may stem from the difficulty in securing funding for assets that are targeting acute pain. Not only is acute pain a much smaller market than chronic pain, but it receives much less attention and likely less capital than disease areas like cardiometabolic, autoimmune, and oncology.

The unmet need in pain management is also largely derived from the addictive risk of opioids and the side effects of NSAIDs, as opposed to an absence of effective pain management. And while adverse effect mitigation is important, it will not drive as much unmet need and thus financial incentives for therapeutic innovation as an efficacy gap would. As for addiction, such behavioral outcomes can be more difficult to generate substantial evidence from robust clinical trials.

The need for non-opioid pain medications is recognized by the healthcare community and is very real, but the urgency of this unmet need and capital required to fund new development programs is lacking.

Because efficacy is not the main source of unmet need, that is also why a lot of the innovation in acute pain management centers on reformulation of existing non-opioid analgesics as opposed to new molecules (see table above summarizing reformulation programs). Numerous assets in development that surfaced during this research were extended release mechanisms, modifications to existing NSAID molecules, localized targeting, and other enhancements to existing pain relief drugs. Only a few of these reoformulation programs were covered in this report. For every novel molecule that is being developed, there appears to be at least one or two times as many programs focused on reformulating an existing pain treatment.

The acute pain drug development landscape is fragmented, ill-funded, and largely occuppied with incremental innovation programs. It appears that only true breakthrough therapies with advancements in pain relief and side effect mitigation combined in a single package have the chance to receive market approval and become a key component of the standard of care.

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References(click to expand)

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[22]“Evaluation of the Long-term Safety and Effectiveness of Suzetrigine (SUZ) in Participants With Painful Diabetic Peripheral Neuropathy (DPN)” · NCT06696443 · Vertex Pharmaceuticals · ClinicalTrials.gov View source
[23]“Evaluation of Efficacy and Safety of Suzetrigine (SUZ) for Pain Associated With Diabetic Peripheral Neuropathy” · NCT07231419 · Vertex Pharmaceuticals · ClinicalTrials.gov View source
[24]“Evaluation of Efficacy and Safety of Suzetrigine for Pain Associated With Diabetic Peripheral Neuropathy” · NCT06628908 · Vertex Pharmaceuticals · ClinicalTrials.gov View source
[25]“Evaluation of Efficacy and Safety of VX-548 for Painful Lumbosacral Radiculopathy (PLSR)” · NCT06176196 · Vertex Pharmaceuticals · ClinicalTrials.gov View source
[26]“Vertex Provides Pipeline and Business Updates in Advance of Upcoming Investor Meetings” · Vertex Pharmaceuticals · January 11, 2026 View source
[27]“Tris Pharma Reports Positive Clinical Results of Intranasal Human Abuse Potential Study Indicating Low Abusability of Cebranopadol, an Investigational, First-in-Class Oral Dual-NMR Agonist for the Treatment of Moderate-to-Severe Pain” · Tris Pharma · January 28, 2025 View source
[28]“A Study of Cebranopadol for the Treatment of Acute Pain After Abdominoplasty (ALLEVIATE1)” · NCT06545097 · Tris Pharma · ClinicalTrials.gov View source
[29]“A Study of Cebranopadol for the Treatment of Acute Pain After Bunionectomy (ALLEVIATE2)” · NCT06423703 · Tris Pharma · ClinicalTrials.gov View source
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[31]Ren et al. · “A randomized, double-blind, placebo-controlled and dose-ranging study to evaluate the safety and efficacy of XG005 in subjects with painful osteoarthritis of the knee” · Osteoarthritis and Cartilage Open · December 19, 2025 View source
[32]“Xgene Pharma Pipeline Overview” · Xgene Pharma View source
[33]Jiang et al. · “Pregabalin Naproxencarbil in Acute Post-Bunionectomy Pain: A Randomized Clinical Trial” · Pain Reports · January 20, 2026 View source
[34]“XG005 for Pain Control in Subjects Undergoing Bunionectomy” · NCT06017999 · Xgene Pharma · ClinicalTrials.gov View source
[35]“Xgene Pharma and NeuroGen Sign Exclusive License Agreement for XG005, an Innovative Non-Opioid Analgesic in China” · Xgene Pharma · July 2025 View source
[36]“ClinicalTrials.gov Search Results: XG005, Phase 3” · ClinicalTrials.gov · ClinicalTrials.gov View source
[37]“Tris Pharma Pain Pipeline” · Tris Pharma View source
[38]“Latigo Biotherapeutics Pipeline” · Latigo Biotherapeutics View source
[39]“An Efficacy and Safety Study of LTG-001 Following Abdominoplasty” · NCT07102459 · Latigo Biotherapeutics · ClinicalTrials.gov View source
[40]“This is a Study Evaluating the Efficacy and Safety of LTG-001 for Acute Pain After Surgical Removal of Impacted Third Molars” · NCT06774625 · Latigo Biotherapeutics · ClinicalTrials.gov View source
[41]“Latigo Biotherapeutics Media and News” · Latigo Biotherapeutics View source
[42]“Latigo Biotherapeutics Granted FDA Fast Track Designation for LTG-001, Potential Best-in-Class Nav1.8 Inhibitor for the Non-Opioid Treatment of Acute Pain” · Latigo Biotherapeutics · March 3, 2025 View source
[43]“A Phase 1 Single and Multiple Ascending Dose Study of LTG-305 Administered Orally in Healthy Participants” · NCT06554574 · Latigo Biotherapeutics · ClinicalTrials.gov View source
[44]“Eli Lilly Research and Development Pipeline” · Eli Lilly and Company View source
[45]“A Study of LY4515100 in Healthy Participants” · NCT07339722 · Eli Lilly and Company · ClinicalTrials.gov View source
[46]“Eli Lilly Clinical Trials Page: LY4515100” · Eli Lilly and Company View source
[47]“Single Ascending Dose Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of ST-2427” · NCT04475198 · SiteOne Therapeutics / Eli Lilly · ClinicalTrials.gov View source
[48]“Neurocarrus Pipeline” · Neurocarrus View source
[49]“Xenon Pharmaceuticals Pipeline” · Xenon Pharmaceuticals View source
[50]“XEN1701 Drug Profile” · AdisInsight (Springer) View source
[51]“Xenon Reports Q1 2026 Financial Results and Provides Business Update” · Xenon Pharmaceuticals · May 7, 2026 View source
[52]“XEN1120 Drug Profile” · AdisInsight (Springer) View source
[53]“AbbVie Inks $715M Deal With Chinese Biotech Haisco for Two Acute Pain Assets” · Fierce Biotech · April 13, 2026 View source
[54]“Phase II Clinical Study of the Efficacy and Safety of HSK55718 in the Treatment of Abdominal Postoperative Pain” · NCT07491146 · AbbVie / Haisco Pharmaceutical Group · ClinicalTrials.gov View source
[55]“Nocion Therapeutics Pipeline and Clinical Trials” · Nocion Therapeutics View source
[56]“Nocion Therapeutics to Present Preclinical Data Supporting Nocion's Novel Approach for the Treatment of Pain at the Non-Opioid Pain Therapeutics Summit” · Nocion Therapeutics · January 26, 2026 View source
[57]“Nocion Therapeutics Announces Full Enrollment in Phase 2b ASPIRE Study of Taplucainium for Chronic Cough” · Nocion Therapeutics · May 5, 2026 View source
[58]Dhillon, S. · “Tegileridine: First Approval” · Drugs · June 2024 View source
[59]Wang et al. · “Tegileridine for Moderate-to-Severe Acute Pain Following Abdominal Surgery: A Randomized, Double-Blind, Phase 3 Clinical Trial” · Cell Reports Medicine · December 8, 2025 View source
[60]“Tegileridine vs Sufentanil for Postoperative Pain Management and Gastrointestinal Recovery After Major Laparoscopic Abdominal Surgery (TASPER)” · NCT07637968 · Shanghai General Hospital · ClinicalTrials.gov View source
[61]“Suzetrigine (NaV1.8 Inhibitors)” · Alzheimer's Drug Discovery Foundation / Cognitive Vitality · April 22, 2025 View source
[62]“A Phase Ⅱ/Ⅲ Study of HRS-2129 for Postsurgical Pain Management in Abdominal Surgery” · NCT07185594 · Shandong Suncadia Medicine · ClinicalTrials.gov View source
[63]“A Study of Single and Multiple Doses of HRS-6257 in Healthy Subjects” · NCT07301333 · Shanghai Hengrui Pharmaceutical · ClinicalTrials.gov View source
[64]Ni et al. · “Pharmacokinetics, Metabolite Profiling, Safety and Tolerability of YZJ-4729 Tartrate, a Novel G Protein-Biased Mu-Opioid Receptor Agonist, in Healthy Chinese Subjects” · Frontiers in Pharmacology · January 8, 2024 View source
[65]“A Study of YZJ-4729 Tartrate Injection for the Treatment of Pain After Abdominal Surgery” · NCT06890533 · Shanghai Haiyan Pharmaceutical Technology · ClinicalTrials.gov View source
[66]“Clinical Trials Search” · China Drug Trials Registry View source
[67]Pan et al. · “Efficacy and Safety of HSK21542 for Pruritus Management in Hemodialysis Patients: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial” · Frontiers in Pharmacology · June 24, 2025 View source
[68]“NMPA 2025 Approved Small Molecule Drugs” · BLD Pharm View source
[69]“A Clinical Trial Evaluating the Efficacy and Safety of HSK21542 in Patients for Postoperative Pain Treatment” · NCT05390905 · Haisco Pharmaceutical Group · ClinicalTrials.gov View source
[70]Zhong et al. · “HSK21542 in Patients With Postoperative Pain: Two Phase 3, Multicentre, Double-Blind, Randomized, Controlled Trials” · Nature Communications · May 24, 2025 View source
[71]“ClinicalTrials.gov Search Results: CA-008” · ClinicalTrials.gov · ClinicalTrials.gov View source
[72]“Concentric Analgesics Announces Completion of $20 Million Financing and Appoints Two New Board Members as It Prepares to Initiate Registration-Enabling Phase 3 Studies for Vocacapsaicin” · BioSpace · January 26 ,2022 View source
[73]“Antibe's Non-Opioid Pain Drug Otenaproxesul Looks Good in Phase IIb Trials” · American Council on Science and Health · August 5, 2020 View source
[74]Wallace et al. · “A Proof-of-Concept, Phase 2 Clinical Trial of the Gastrointestinal Safety of a Hydrogen Sulfide-Releasing Anti-Inflammatory Drug” · British Journal of Pharmacology · February 2020 View source
[75]“Antibe Therapeutics Pipeline Overview” · Antibe Therapeutics View source
[76]“Antibe Announces FDA Clinical Hold on Otenaproxesul and Legal Action by Nuance” · BioSpace · April 1, 2024 View source
[77]“Neumentum Media and News” · Neumentum View source
[78]“A Dental Pain Study to Test the Effectiveness of a New Pain Reliever Medicine” · NCT02209181 · McNeil Consumer Healthcare / Neumentum · ClinicalTrials.gov View source
[79]“Orion aims to challenge Vertex with new pain management licensing deal” · Fierce Biotech · May 6, 2022 View source
[80]“Orion Pharma Pipeline” · Orion Pharma View source
[81]“CHRONOS - A study to learn about the effects and safety of ODM-111 in participants with long-lasting pain due to osteoarthritis of the knee.” · EU Clinical Trials Information System (CTIS) View source
[82]“Fermion and Simcere Enter into an Exclusive License and Collaboration Agreement for China’s First SSTR4 Agonist Targeting Pain” · BioSpace · January 19, 2025 View source
[83]“Guangzhou Fermion Technology Pipeline” · Guangzhou Fermion Technology View source
[84]“Algomedix Product Pipeline” · Algomedix View source
[85]“Neumentum Pipeline: NTM-001” · Neumentum View source
[86]“Allay Tx Pipeline: ATX-101” · Allay Tx View source
[87]“Cali Biosciences Pipeline: CPL-1” · Cali Biosciences View source
[88]“Viatris Pipeline: MR-107A-02” · Viatris View source
[89]“Lipocure Pipeline: LC-400” · Lipocure View source

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Acute Pain Drug Development Landscape: The Era of Non-Addictive Pain Meds

Journavx's Approval

Journavx Commercial Outcomes

Novel Therapeutic Strategies

Acute Pain Pipeline Overview

Acute Pain Pipeline Deep Dive

1. Suzetrigine (Vertex Pharma)

2. Cebranopadol (Tris Pharma)

3. XG005 (XGene Pharma)

4. TRN-261 (Tris Pharma)

5. LTG-001 (Latigo Biotherapeutics)

6. LY4515100 (Eli Lilly)

7. N-001 (Neurocarrus)

8. XEN1701 (Xenon Pharma)

9. XEN1120 (Xenon Pharma)

10. HSK55718 (AbbVie)

11. Undisclosed Asset (Nocion Therapeutics)

Assets with Current Development Focus Exclusively in China

12. Tegileridine (Jiangsu Hengrui Medicine)

13. Susineridine (Shanghai Haiyan Pharmaceutical Technology)

14. Anrikefon (Haisco Pharmaceutical Group)

Additional Pipeline Considerations: Assets with Unknown Development Statuses or Discontinuation

Additional Pipeline Considerations: Reformulations of Existing Molecules

Concluding Remarks

Read the full report

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