Suzetrigine: A potential alternative for palliative pain management in Pakistan's opioid-restricted healthcare system

Background Palliative care aims to improve the quality of life for patients with terminal illnesses by addressing physical, psychological, and social needs. However, only 14% of individuals globally who need palliative care receive it. In Pakistan, the availability is critically low, with a palliative care-to-population ratio of 1:90 million. Access to strong opioids for pain relief is severely restricted, with only 2% of terminally ill patients receiving adequate analgesia. These limitations, driven by concerns over opioid misuse and regulatory restrictions, highlight the urgent need for effective, accessible non-opioid alternatives. Suzetrigine, a novel NaV1.8 channel inhibitor, may offer a promising solution. Methods This brief review summarizes clinical trial data from multiple Phase 2 and Phase 3 studies evaluating the efficacy and safety of Suzetrigine in managing acute and chronic pain. Primary endpoints included the time-weighted sum of pain intensity difference over 48 hours and weekly average pain score reductions assessed using the numeric pain rating scale. The implications of these findings were contextualized in the setting of Pakistan's opioid-restricted palliative care landscape. Results Suzetrigine demonstrated statistically and clinically significant analgesic effects in trials involving postoperative pain, lumbar radiculopathy, and diabetic neuropathy. The drug was well-tolerated, with adverse events such as nausea, headache, and constipation being mild and infrequent. Conclusion Suzetrigine presents a viable non-opioid analgesic alternative for palliative care in Pakistan, where regulatory and systemic barriers limit opioid access. Its introduction could enhance pain management, reduce opioid-related harms, and support the development of a safer, more accessible palliative care model.