The acute pain market reached $4.5B in 2025, with 98% of pain drugs generic. Voltage-gated sodium channel inhibitors like Journavx offer non-opioid relief, while 39% of the pipeline uses non-small-molecule modalities.
Lidocaine patches cut opioid use after radiofrequency ablation for hepatocellular carcinoma; a protocol tests liposomal bupivacaine for mastectomy; a pipeline report profiles 40+ companies.
Vertex Pharmaceuticals dominates cystic fibrosis therapies with TRIKAFTA/KAFTRIO generating $2.57 billion in Q4 2025 and ALYFTREK ramping to $380.1 million. The company posted strong free cash flow of $3.19 billion in 2025 and is expanding into pain, kidney disease, and gene-editing therapies.
Grünenthal has successfully completed a Phase I trial for its proprietary nociceptin receptor (NOP) agonist, demonstrating safety and tolerability in 113 healthy volunteers. The company plans to advance the novel pain therapy into a Phase II trial later this year, with results expected in the second half of 2027.
Vertex completed the rolling BLA submission for povetacicept in IgA nephropathy after positive Phase 3 RAINIER interim data. The company plans to use a Priority Review Voucher to accelerate FDA review.
The FDA approved 46 novel drugs in 2025, down from 50 in 2024. Small molecules accounted for 31 approvals (67%), with oncology leading at nine approvals. Large molecules contributed 15 approvals (33%), spanning ADCs, bispecifics, and subcutaneous delivery innovations.
| NCT ID | Title | Status | Phase |
|---|---|---|---|
| NCT07778069 |
VR for Steroid Joint Injections - Feasibility |
ENROLLING_BY_INVITATION | NA |
| NCT07740837 |
Fan-Assisted Local Cooling for Pain During Intravenous Cannulation in Adults |
COMPLETED | NA |
| NCT07739277 |
Transverse vs. Longitudinal Serratus Anterior Plane Block in Breast Surgery |
RECRUITING | NA |
| NCT07738770 |
Analgesic Efficacy of Combined PECS II and PIP Block Versus Thoracic Paravertebral Block Post-Mastectomy |
RECRUITING | NA |
| NCT07735884 |
Comparison of Ultrasound-Guided Fascia Iliaca Compartment Block Versus Intravenous Tramadol for Positioning of Femur Fracture Patients Before Spinal Anaesthesia |
COMPLETED | NA |
| NCT07717762 |
Building a Swiss Pain Registry: A National Framework for Acute and Chronic Pain Assessment |
NOT_YET_RECRUITING | |
| NCT07702071 |
BLOCK-TRAUMA Study |
NOT_YET_RECRUITING | |
| NCT07698665 |
Ketamine Versus Dexmedetomidine as an Adjuvant in Scalp Block in Supratentorial Brain Tumor Excision Surgeries |
RECRUITING | NA |
| NCT07694180 |
Postoperative Outcomes of Regional Blocks in Cervical Disc Surgery |
NOT_YET_RECRUITING | |
| NCT07683663 |
QIPB vs SI-FICB for Postoperative Analgesia After Total Hip Arthroplasty |
NOT_YET_RECRUITING | NA |
