Suzetrigine (a NaV1.8 inhibitor) versus placebo for acute postoperative pain: A systematic review and meta-analysis of randomized controlled trials
Abstract
BACKGROUND: NaV1.8 channels, expressed in peripheral nociceptors, mediate sustained pain signaling. Their inhibition offers a potential opioid-sparing strategy for postoperative pain, although efficacy and safety remain incompletely defined. We synthesized randomized evidence for suzetrigine versus placebo in postoperative pain.
METHODS: We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant meta-analysis of randomized controlled trials comparing suzetrigine (a NaV1.8 inhibitor) versus placebo in surgical patients. The primary outcome was 24-hour pain with the Numeric Pain Rating Scale; secondary outcomes included 48-hour pain, change-from-baseline, and adverse events. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool, and for analyses, we used Hartung-Knapp models with heterogeneity and prediction intervals reported. Random-effects models used Hartung-Knapp adjustments (2-sided α = 0.05).
RESULTS: We included 4 randomized datasets across 2 phase 3 publications (n = 1584; 1009 intervention, 575 placebo). The mean participant age was 44.9 years; 92.3% were women. Procedures included abdominoplasty (n = 823) and bunionectomy (n = 761). Suzetrigine significantly reduced pain at 24 hours (mean difference = -0.93; 95% confidence interval [CI], -1.38 to -0.48; I2 = 66.0%) and 48 hours (mean difference = -1.02; 95% CI, -1.32 to -0.72; I2 = 11.8%). Analyses of change-from-baseline confirmed consistent benefit. Subgroup analyses…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,584 participants or records.
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