Viatris Inc. announced today that its novel fast-acting meloxicam formulation (MR-107A-02) achieved positive top-line results in two pivotal Phase 3 clinical trials for the treatment of moderate-to-severe acute pain. The studies demonstrated statistically significant and clinically meaningful improvements in pain control compared to placebo, while also showing superior efficacy to an opioid comparator.
The Phase 3 program evaluated MR-107A-02 in two distinct surgical pain models: herniorrhaphy (hernia repair) and bunionectomy. Both randomized, double-blind, placebo- and active-controlled trials met all primary and secondary endpoints, positioning the investigational drug as a potential non-opioid alternative for acute pain management.
Superior Pain Control with Reduced Opioid Use
In both surgical models, MR-107A-02 demonstrated significant pain reduction compared to placebo as measured by the Sum of Pain Intensity Difference (SPID) over 48 hours. In the herniorrhaphy trial, which enrolled 579 subjects, the least squares mean difference in SPID0-48h between MR-107A-02 and placebo was 50.1 (95% CI: 35.4, 64.8; p<0.001). The bunionectomy trial, with 410 subjects, showed an even larger effect with a difference of 82.7 (95% CI: 62.0, 103.4; p<0.001).
Notably, post-hoc analyses revealed that MR-107A-02 provided significantly superior pain control compared to tramadol (50mg q6h), the opioid comparator used in both studies. The novel meloxicam formulation also demonstrated a faster onset of action, with significantly shorter time to both perceptible and meaningful pain relief versus placebo, and performance that was shorter or comparable to tramadol.
"Building on an established mechanism of action and well-characterized safety profile, the efficacy and benefit-risk profile observed in these two pivotal studies optimally positions our fast-acting meloxicam for potential first-line treatment of moderate-to-severe acute pain," said Philippe Martin, Viatris Chief R&D Officer. "The data observed in two surgical models is a critical step in the development of a safe and effective non-opioid option to address an important public health need."
Significant Reduction in Opioid Requirements
One of the most clinically significant findings was MR-107A-02's impact on reducing or eliminating the need for opioid rescue medication. In the herniorrhaphy trial, 72.6% of patients receiving MR-107A-02 remained opioid-free throughout the study period, compared to 58.6% in the placebo group (p=0.002). Similarly, in the bunionectomy trial, 56.9% of MR-107A-02 patients were opioid-free versus just 33.1% in the placebo arm (p<0.001).
Dr. Todd Bertoch, a board-certified anesthesiologist and Chief Medical Officer for Pain Research at CenExel who has been involved with the program since its Phase 2 dental pain study in 2022, commented on the consistency of results: "It is rare to see such positive data replicated in three different trials. The efficacy and safety data of the novel, fast-acting meloxicam from two Phase 3 studies in both bony and soft tissue pain models supports its potential use as a powerful, first-line, non-opioid analgesic option for patients with moderate-to-severe acute pain – potentially eliminating opioid use altogether for many patients."
Safety Profile and Tolerability
MR-107A-02 was generally well tolerated across both studies. The incidence of treatment-emergent adverse events (TEAEs) was comparable to placebo in the post-surgical setting. Few severe TEAEs and severe adverse events (SAEs) were reported, with rates consistent with placebo. No treatment-related deaths occurred during the studies.
Trial Design and Methodology
Both Phase 3 trials followed similar designs, enrolling post-operative patients aged 18 or older who experienced moderate-to-severe pain following either herniorrhaphy or bunionectomy surgery. Patients were randomized to receive either MR-107A-02, tramadol (50mg q6h), or placebo.
During the inpatient phase (0-48 hours), subjects received eight doses of the study drug administered every six hours. To maintain blinding, subjects in the MR-107A-02 group received active drug and placebo alternately. The outpatient phase continued for five additional days, with subjects receiving the study drug twice daily (10 doses). Patients initially randomized to tramadol during the inpatient phase received placebo during the outpatient phase.
Addressing a Significant Unmet Need
Acute pain affects more than 80 million individuals in the United States annually and is a primary driver of emergency department visits and postoperative morbidity. Despite its prevalence, more than half of surgical patients report inadequate pain relief with current treatment options.
The economic burden of acute pain is substantial, encompassing both direct medical expenses and indirect costs such as lost productivity and disability. Additionally, inadequate pain control can contribute to delayed recovery, impaired physical function, poor sleep, and reduced quality of life.
Current pain management approaches often rely heavily on opioids, which carry risks of dependence, misuse, and adverse effects. The development of effective non-opioid alternatives with rapid onset and favorable safety profiles represents a significant unmet medical need.
Regulatory Pathway and Next Steps
Based on the positive results from these two Phase 3 studies, along with supportive data from a previous Phase 2 dose-ranging study in dental pain, Viatris plans to submit a New Drug Application to the U.S. Food and Drug Administration by the end of 2025.
The company indicated that full results from both Phase 3 studies will be submitted for presentation at upcoming scientific conferences, including the PAINWeek 2025 conference scheduled for September.
Additional information about the Phase 3 program will be made available in Viatris's Q1 2025 Earnings Presentation, accessible through the company's investor relations website.
