Suzetrigine for Acute Pain Control in Patients With Multiple Rib Fractures

NCT ID: NCT07145346

Last Updated: 2025-11-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-13

Study Completion Date

2027-08-31

Brief Summary

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Rib fractures cause a significant amount of pain and are associated with an increased risk of lung infections, long hospitalization, and increased cost. Effective pain control is the cornerstone of management to improve lung function and minimize complications. Most often this is done with a multimodal pain routine consisting of: acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), topical lidocaine, muscle relaxants, and opioids. However, suzetrigine is a promising alternative to treat acute pain associated with rib fractures. We think the addition of suzetrigine to a multimodal pain regimen will improve pain and decrease opioid use.

Detailed Description

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Rib fractures are a common and painful injury associated with increased risk of pneumonia, prolonged hospitalization, and higher healthcare utilization. In a national database review, rib fractures were associated with a 10% mortality rate, with mortality increasing incrementally with each additional rib fractured. Effective analgesia is essential in management of these injuries, as improved pain control optimizes pulmonary mechanics and reduces complications. Current analgesic strategies include multimodal pain regimens consisting of oral and transdermal analgesics or regional anesthetics such as epidural catheters. Historically, opioids have been a major component of analgesia, however they are highly addictive and can lead to respiratory depression and epidurals are invasive procedures with associated risks.

Suzetrigine (Journavx) is a newly United States Food and Drug Administration (FDA)-approved, oral non-opioid analgesic that selectively inhibits the NaV1.8 voltage-gated sodium channel, which is solely expressed in peripheral nociceptive neurons. A systematic review including multiple phase III trials demonstrated suzetrigine's efficacy for pain management in both non-surgical and post-surgical patients. Suzetrigine has also been shown to have comparable analgesia to oral opioids with fewer side effects, such as nausea, vomiting, and need for rescue pain medication.

Conditions

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Rib Fractures

Keywords

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blunt chest trauma rib fractures Suzetrigine multimodal pain regimen

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, randomized, double-blinded, placebo-controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
Patients will be randomized independently by a third party not involved in patient care or data extraction. Researchers and care providers will be blinded to which arm they are in for the duration of the trail.

Study Groups

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Suzetrigine arm

The intervention arm will receive oral suzetrigine (100 mg loading dose followed by 50 mg every 12 hours).

Group Type EXPERIMENTAL

Suzetrigine (SUZ)

Intervention Type DRUG

The intervention arm will receive oral suzetrigine (100 mg loading dose followed by 50 mg every 12 hours).

Control arm

The control arm will receive placebo capsules matched to suzetrigine for oral administration.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

The control arm will receive placebo capsules matched to suzetrigine for oral administration.

Interventions

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Suzetrigine (SUZ)

The intervention arm will receive oral suzetrigine (100 mg loading dose followed by 50 mg every 12 hours).

Intervention Type DRUG

Placebo

The control arm will receive placebo capsules matched to suzetrigine for oral administration.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* \> 18 years old
* Blunt trauma patients
* \> 3 rib fractures
* Able to tolerate oral intake

Exclusion Criteria

* \< 17 years old
* Pregnant
* Prisoners
* History of adverse reaction to suzetrigine
* Current strong CYP3A inhibitor medication use

o Strong Inhibitors: clarithromycin, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, atazanavir, darunavir, indinavir, lopinavir, telithromycin
* Current strong or moderate CYP3A inducer

* Strong Inducers: apalutamide, carbamazepine, encorafenib, enzalutamide, fosphenytoin, lumacaftor and ivacaftor, mitotane, phenytoin, rifampin
* Moderate Inducers: bexarotene (Systemic), bosentan, cenobamate, dabrafenib, dipyrone, efavirenz, elagolix, estradiol, and norethindrone, eslicarbazepine, etravirine, fexinidazole, lorlatinib, mitapivat, modafinil, nafcillin, pacritinib, pexidartinib, phenobarbital, primidone, repotrectinib, rifabutin, rifapentine, sotorasib, St John's Wort
* Cirrhosis
* GCS \< 14
* Rhabdomyolysis (CPK \> 5,000 U/L)
* Chronic opioid use (\>30mg OME/day)
* Known or suspected active infection with human immunodeficiency virus or hepatitis B or C viruses
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, Irvine

OTHER

Sponsor Role lead

Responsible Party

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Jeffrey Nahmias, MD

Chief, Division of Trauma, Burns and Surgical Critical Care

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of California, Irvine

Orange, California, United States

Site Status

Countries

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United States

Central Contacts

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Jeffry Nahmias, MD, MHPE

Role: CONTACT

Phone: 714-456-5890

Email: [email protected]

Peter D Nguyen, MD

Role: CONTACT

Phone: 714-509-2377

Email: [email protected]

Facility Contacts

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Jeffry Nahmias, MD, MHPE

Role: primary

Peter D Nguyen, MD

Role: backup

References

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Galvagno SM Jr, Smith CE, Varon AJ, Hasenboehler EA, Sultan S, Shaefer G, To KB, Fox AD, Alley DE, Ditillo M, Joseph BA, Robinson BR, Haut ER. Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society. J Trauma Acute Care Surg. 2016 Nov;81(5):936-951. doi: 10.1097/TA.0000000000001209.

Reference Type BACKGROUND
PMID: 27533913 (View on PubMed)

Stawicki SP, Grossman MD, Hoey BA, Miller DL, Reed JF 3rd. Rib fractures in the elderly: a marker of injury severity. J Am Geriatr Soc. 2004 May;52(5):805-8. doi: 10.1111/j.1532-5415.2004.52223.x.

Reference Type BACKGROUND
PMID: 15086666 (View on PubMed)

Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000 Jun;48(6):1040-6; discussion 1046-7. doi: 10.1097/00005373-200006000-00007.

Reference Type BACKGROUND
PMID: 10866248 (View on PubMed)

Carver TW, Kugler NW, Juul J, Peppard WJ, Drescher KM, Somberg LB, Szabo A, Yin Z, Paul JS. Ketamine infusion for pain control in adult patients with multiple rib fractures: Results of a randomized control trial. J Trauma Acute Care Surg. 2019 Feb;86(2):181-188. doi: 10.1097/TA.0000000000002103.

Reference Type BACKGROUND
PMID: 30376537 (View on PubMed)

Schnabel A, Meyer-Friessem CH, Reichl SU, Zahn PK, Pogatzki-Zahn EM. Is intraoperative dexmedetomidine a new option for postoperative pain treatment? A meta-analysis of randomized controlled trials. Pain. 2013 Jul;154(7):1140-9. doi: 10.1016/j.pain.2013.03.029. Epub 2013 Mar 27.

Reference Type BACKGROUND
PMID: 23706726 (View on PubMed)

Peng K, Zhang J, Meng XW, Liu HY, Ji FH. Optimization of Postoperative Intravenous Patient-Controlled Analgesia with Opioid-Dexmedetomidine Combinations: An Updated Meta-Analysis with Trial Sequential Analysis of Randomized Controlled Trials. Pain Physician. 2017 Nov;20(7):569-596.

Reference Type BACKGROUND
PMID: 29149140 (View on PubMed)

Zhang X, Wang D, Shi M, Luo Y. Efficacy and Safety of Dexmedetomidine as an Adjuvant in Epidural Analgesia and Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Drug Investig. 2017 Apr;37(4):343-354. doi: 10.1007/s40261-016-0477-9.

Reference Type BACKGROUND
PMID: 27812971 (View on PubMed)

Gerlach AT, Murphy CV, Dasta JF. An updated focused review of dexmedetomidine in adults. Ann Pharmacother. 2009 Dec;43(12):2064-74. doi: 10.1345/aph.1M310.

Reference Type BACKGROUND
PMID: 19934395 (View on PubMed)

Flagel BT, Luchette FA, Reed RL, Esposito TJ, Davis KA, Santaniello JM, Gamelli RL. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005 Oct;138(4):717-23; discussion 723-5. doi: 10.1016/j.surg.2005.07.022.

Reference Type BACKGROUND
PMID: 16269301 (View on PubMed)

Other Identifiers

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7663

Identifier Type: -

Identifier Source: org_study_id