Plug your sodium channels with VX-548
A couple times a year we see headlines about thrilling advances in the war against pain. Scientific American: “New Painkiller Could Bring Relief to Millions—Without Addiction Risk.” The article strongly implies that VX-548 is a major upgrade, more powerful and less addictive than opioids.
That’s … unlikely.
And I am always preemptively underwhelmed by these stories, and irritated by their predictable format:
- Give pain a face! “When doctors ask Sara Gehrig to describe her pain, she often says it is indescribable.”
- Elevator pitch for how it works: “Blocks pain signals before they can reach the brain. It gums up sodium channels [NaV1.8] in peripheral nerve cells … because the drug acts only on the peripheral nerves, it does not carry the potential for addiction.”
- “Promising results” are cited, FDA approval is pending, and the manufacturer is named (because the article is just a dressed up press release).
- Obligatory paragraph of horrifying stats about chronic pain.
Like fusion power, safe and strong pain-killers have been thirty years away for decades, because there are basic reasons in principle why killing pain is hard. Pain has many possible causes, and it’s so integrated into our physiology that it’s nearly impossible to mute without also disabling critical subsystems at the same time — which is why
And the VX-548 data to date can already curb your enthusiasm: it beat a placebo for acute post-surgical pain, but … only in high doses … and it “did not beat a cheap, off-patent opioid-based regimen in either trial.” A disappointment strangely neglected by the press release!
It is cool that this drug targets peripheral nerves. If it actually works about as well as hydrocodone, but can’t be abused, it may yet be a big deal.
But it probably won’t be cheap, and therefore accessible — how could it be? A major investment must be recouped! And it isn’t obviously a game changer that will “bring relief to millions.”
No one believes hype in headlines anymore, though… right?