Emerging Field of Biased Opioid Agonists

Anuj K Aggarwal

doi:10.1016/j.anclin.2023.02.001

Emerging Field of Biased Opioid Agonists

Anesthesiol Clin. 2023 Jun;41(2):317-328. doi: 10.1016/j.anclin.2023.02.001. Epub 2023 Mar 15.

Author

Anuj K Aggarwal¹

Affiliation

¹ Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: akaggarw@stanford.edu.

PMID: 37245944
DOI: 10.1016/j.anclin.2023.02.001

Abstract

Advances in opioid pharmacology promise to bring a "better opioid." Biased opioid agonists, designed to recruit G protein over β-arrestin signaling, may provide analgesia without adverse effects of traditional opioids. Oliceridine, the first biased opioid agonist, was approved in 2020. In vitro and in vivo data present a complicated picture, with decreased gastrointestinal and respiratory adverse effects but similar abuse potential. Advances in pharmacology will result in new opioids brought to market. However, lessons learned from the past implore appropriate safeguards to patient safety and critical evaluation of the data and science behind new drugs.

Keywords: Agonists; G-protein coupled receptors; Opioids; Perioperative medicine; Pharmacology.

Publication types

Review

MeSH terms

Analgesia*
Analgesics, Opioid* / adverse effects
Humans
Pain
Pain Management
Receptors, Opioid, mu

Substances

Analgesics, Opioid
Receptors, Opioid, mu