Why carry out this study?

Postoperative nausea and vomiting (PONV) are frequent complications following surgery and use of conventional opioids increases risk of PONV.

Oliceridine, a new class of IV opioid, is a G protein-selective agonist at the μ-opioid receptor. This selectivity results in potent analgesia with substantially reduced recruitment of β-arrestin, a signaling pathway associated with opioid-related adverse events.

In two randomized, placebo- and active-controlled phase 3 studies, we have previously reported that oliceridine administered via PCA provided effective analgesia with improvements in gastrointestinal (GI) tolerability profile compared to morphine.

To further characterize the GI tolerability profile of oliceridine vs. morphine after controlling for analgesia, we performed an exploratory analysis that utilized a composite endpoint, “complete GI response” defined as the proportion of patients with no vomiting and no use of rescue antiemetic. This analysis was conducted for the individual studies and the pooled data from both studies.

What was learned from the study?

In the unadjusted analysis, oliceridine had a favorable advantage compared to morphine related to the safety endpoint of “complete GI response”.

The findings persisted when adjusted for the level of analgesia, with the odds of achieving complete GI response being 2–3 times higher with oliceridine than with morphine.