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nalbuphine

Phase 2

Prurigo Nodularis | Small molecule | Other |Trevi Therapeutics, Inc.|Last Updated: Jun 24, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment451
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT03497975PRISM Study-Pruritus Relief Through Itch Scratch ModulationPHASE2 COMPLETED 353Aug 7, 2018Feb 24, 2023Jun 24, 202570 United States, Austria +3
NCT02174432Open Label Extension Study of Nalbuphine HCl ER in Patients With Prurigo NodularisPHASE2 COMPLETED 36Aug 15, 2015Sep 3, 2017May 21, 20251 Germany
NCT02174419Study of Nalbuphine HCl ER Tablets in Patients With Prurigo NodularisPHASE2 COMPLETED 62Mar 1, 2015Aug 1, 2016May 21, 20254 United States, Germany +1
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Study Endpoints
Primary Endpoints
Percentage of Participants With ≥ 4- Point Decrease in 7-day Average Worst Itch - Numerical Rating Scale (WI-NRS) up to Week 14
Baseline up to Week 14

The NRS is a patient related outcome (PRO) instrument, designed to quantify the intensity of worst itching experienced during a 24-hour period, and can be applied and validated either with reference to the average itch or to the absolute worst itch (WI-NRS) over that 24-hour period. WI-NRS is a set of boxes, one for each number, from 0 (no itching) to 10 (worst possible itching). Higher scores indicate worst itching experience. Responder was defined as a participant with a ≥4-point decrease in the 7-day average WI-NRS from baseline to Week 14.

Overall Incidence and Nature of Treatment Emergent Adverse Events (TEAEs)
50 weeks

Incidence of adverse events is calculated based on events observed on or after the date of first dose, where incidence is defined as the number of subjects who reported one or more events of a particular adverse event divided by the number of subjects who received at least one dose of investigational product. Overall incidence is the proportion of subjects who had one or more adverse events of any type and nature pertains to the incidence of individual events coded by MedDRA nomenclature. An additional consideration was to evaluate incidence of adverse events by dose achieved but this was not done as subjects achieved a maximum dose during the study that varied and, per protocol, dosing could be modified per the investigator, during the course of this extension to TR03. In addition, TR03EXT involved a dose titration whereas events could have been reported well before a subject achieved some partciular dose level. Consequently, such a presentation would have been impossible to discern.

Change From Baseline to the Evaluation Visit (Week 10) in Itch on the 0-10 Numerical Rating Scale
Baseline, Week 10

The number of subjects who reported at least a 30% reduction from baseline to Week 10, expressed as a percentage of subjects in the particular arm/group who were evaluated,

Secondary Endpoints
Change From Baseline in Itch-related Quality of Life (ItchyQoL) Total Score at Week 14
Baseline, Week 14
Change From Baseline in Prurigo Activity Score (PAS) Assessed by the Percentage of Participants With 1-Category Improvement in the Percentage of Pruriginous Lesions With Excoriations/Crusts (Item 5a) at Week 14
Baseline, Week 14
Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form 8a at Week 14
Baseline, Week 14
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
NAL EREXPERIMENTALDuring the double-blind (DB) period, participants were titrated over 2 weeks to NAL ER 162 mg, orally, twice daily (BID), followed by 162 mg, orally, BID, for 12 weeks. During the open label extension (OLE) period, participants perceived a titration period of 2 weeks, and continued to receive NAL ER 162 mg, orally, BID, for 38 weeks in total.
PlaceboPLACEBO_COMPARATORDuring the DB period, participants perceived a titration period of 2 weeks during which they received placebo to match the active titration period, followed by placebo, orally, BID, for 12 weeks. During the OLE period, participants were titrated over 2 weeks to NAL ER 162 mg, orally, BID, which they received for 38 weeks (including titration).
nalbuphine HCl EREXPERIMENTALnalbuphine HCl ER
nalbuphine HCl ER 90mgEXPERIMENTALnalbuphine HCl ER tablets 90 mg BID
nalbuphine HCl ER 180 mgEXPERIMENTALnalbuphine HCl ER tablets 180 mg BID
Sugar pillPLACEBO_COMPARATORPlacebo tablets BID
Interventions
NameTypeDescription
Nalbuphine ER TabletsDRUGActive Nalbuphine ER Tablets
Placebo TabletsDRUGPlacebo matching NAL ER with no active substance
nalbuphine HCl ERDRUGnalbuphine HCl ER BID for up to 50 weeks
nalbuphine HCl ER tablets 90 mg BIDDRUGnalbuphine HCl ER tablets 90 mg BID administered for 8 weeks
nalbuphine HCl ER tablets 180 mg BIDDRUGnalbuphine HCl ER tablets 180 mg BID administered for 8 weeks
Placebo tablets BIDDRUGPlacebo tablets BID administered for 10 weeks
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites70

Inclusion Criteria: * Individuals diagnosed with generalized nodular PN, covering 2 separate body parts, and 10 or more pruriginous nodules * Severe itch due to PN * Age 18 years and older at the time of consent, and a life expectancy of at least 18 months. * Individuals using antidepressants must ...

Countries:United StatesAustriaFranceGermanyPoland
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