Transcript
A (0:00)
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B (0:19)
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C (0:34)
Welcome to Paging Dr. Gupta. This is the show where I get to hear directly from you, and I love it. You get to send me your health questions, I get to answer them. And you've been sending in a lot of questions. Kira, one of our producers, she's back with us today as well. Kira, who's paging us first.
D (0:54)
Hey, Sanjay. So first up today, we've got a really interesting question coming from listener Stephanie, who wants to know about this new FDA approved painkiller. What's the deal and how is it different from other prescription pain meds?
C (1:10)
All right, Stephanie, a really important question. Something that I think a lot about pain. You know, as a neurosurgeon, I in many ways am taking care of a lot of patients who have pain. And there's been a real need for new options to try and treat pain. This may shock you, but in the United States, there's not been a new medication approved for pain in more than 25 years. I think it was 1998. Celebrex was approved. Despite the fact that the FDA approves dozens of drugs every year for all kinds of different things. We haven't made any progress in pain until now. The new medication we're talking about is called Suzetrogine. It's going to be sold under the brand name Journavax. Here's how you should think about it, Stephanie. Opioid pain medications, which you're probably familiar with, the way that they work is really by dulling the pain, acting on the brain, essentially muting the sensation, if you will. Pain does not exist until the brain decides that it exists. Okay? Brain processes pain, and that's where opioids work by basically dulling that sensation. Pain signal goes to the brain, the brain processes it, and the opioids sort of interfere with that process. Journavax, this new medication we're talking about, works in a completely different way. It essentially prevents the pain signaling from firing in the first place. There's a signal that would go from the Source of pain, your foot, your hand, whatever goes to the brain, it prevents that signaling from happening in the first place. So it's very different than how opioids work. Let me tell you a quick backstory, because this story is fascinating, of how this drug came about. There was a family in Pakistan that people had noticed were able to do things like walk on very hot coals without flinching. Now, what was extraordinary about them was not just that they could walk on the hot coals, but that they could feel the coals and they could feel that they were hot, but they did not have pain. What does that mean? That means it wasn't that they were numb to the coals, or insensate, as we call it. It's rather that they specifically did not have pain. Pain signaling. So that was a really interesting thing. So they studied this family, they found that they had a certain gene in common, and that gene was what was actually stopping the firing of those pain signals. So what this medication, susetragine, really is, is the byproduct of 25 years of work trying to replicate what that gene is able to do. It is able to take away pain sensation from a period of time. This is a medication that you would take every 12 hours, for example, when you have pain. One thing I just want to explain, neurons communicate in the body basically using nerve impulses. So sending one signal to the next neuron, to the next neuron, it's kind of like Morse code. And those impulses are powered by tiny molecular batteries called sodium channels. What Journavax does, it targets and blocks one of those sodium channels, specifically the sodium channel responsible for carrying the pain signal. Now, because it's not working on the brain, you're not getting the euphoria that's associated with opioids. And that's why you don't have really the risk of addiction or dependence. There are side effects, as all medications have side effects. Itching, muscle spasms. There's also the increase of certain proteins in the blood that are often associated with stressed muscles. So that's something doctors have to keep an eye on. Some people have developed a rash, but side effects were generally pretty mild. Right now, something important to point out is Journavax is really approved for acute pain, for pain that is just in the short term. Think broken bones, post surgery, things like that. The drug was tested on chronic back pain, particularly something known as sciatica, but the results weren't great. Patients reported about a two point reduction in pain. So if you had a pain that was a 7 out of 10. It may have reduced it to a 5 out of 10. So some benefit, but really no better than even just a regular placebo. So we will see how this sort of unfolds over the next months and years. It's about 15 bucks per 50mg pill. We'll see what insurance does with this. But again, Stephanie, I'm glad you asked the question because it is a big deal in terms of the world of pain to have a new option the first time in about 25 years. Now coming up, many of you been wondering, with this year's flu season hitting hard, is it too late now to get your flu shot? We're going to tackle that right after the break.