OREX-1019: a novel treatment for opioid use disorder and relapse prevention

David Maguire, Lisa Gerak, Gerta Cami-Kobeci, Stephen Husbands, Charles France, Barbara Belli, Peter Flynn

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

There is an urgent need for new pharmacological treatments for substance use disorders, including opioid use disorder, particularly for use in relapse prevention. A combination of buprenorphine with naltrexone has shown particular promise, with clinical studies indicating a substantial improvement over treatment with naltrexone alone. OREX-1019 (formerly BU10119) is a compound that mimics the pharmacology of the buprenorphine/naltrexone combination. This study evaluated, in rhesus monkeys, the therapeutic potential of OREX-1019 for treating opioid use disorder. Pretreatment with OREX-1019 (0.01-0.3 mg/kg s.c.) dose-dependently decreased responding for the mu opioid receptor agonist remifentanil in rhesus monkeys but did not maintain levels of responding above vehicle when it was available for self-administration. OREX-1019 (0.01-1.0 mg/kg s.c.) also decreased cue- plus heroin-primed reinstatement of extinguished responding in monkeys that self-administered remifentanil but did not alter cue- plus cocaine-primed reinstatement of responding in monkeys that self-administered cocaine. OREX-1019 (0.3 mg/kg s.c.), like naltrexone (0.1 mg/kg s.c.), increased heart rate and blood pressure, produced overt observable signs, and eliminated food-maintained responding in monkeys treated chronically with morphine. These results confirm that OREX-1019 has little or no efficacy at mu opioid receptors, low abuse potential, and combined with promising safety (clean profile versus other off-target proteins including the hERG channel) and pharmacokinetic data (supporting administration by subcutaneous or sublingual routes, but with low oral bioavailability), suggest it could be a safe and effective alternative to current treatments for opioid use disorders particularly as applied to relapse prevention.
Original languageEnglish
Pages (from-to)205-215
JournalJournal of Pharmacology and Experimental Therapeutics
Volume372
Issue number2
Early online date20 Nov 2019
DOIs
Publication statusPublished - 1 Feb 2020

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