Trevi Therapeutics CEO Jennifer Good joined Steve Darling from Proactive to discuss the company’s progress in advancing its cough treatment pipeline using nalbuphine, a mixed agonist-antagonist opioid. Originally developed for acute indications, nalbuphine is now being repurposed due to its dual mechanism of action, working both peripherally in the lungs and centrally in the brainstem, offering a novel approach to treating chronic cough disorders.
Trevi initially explored multiple indications, including skin conditions caused by severe itching and neurological cough. However, compelling clinical data led the company to focus on cough-related indications. Good explained, “We thought our drug was different because not only does it work peripherally in the lung, it works centrally at the brain, which mediates coughing and breathing.”
The company is now targeting three key areas: interstitial lung diseases (including idiopathic pulmonary fibrosis, or IPF), refractory chronic cough (RCC), and other neurological cough conditions. Following promising Phase 2a results in RCC—an area where many previous drug candidates have failed—Trevi is preparing for a Phase 2b dose-ranging study. If successful, only one pivotal study may be required before regulatory filing.
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