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LT1001

Post-operative pain

The WHO estimated that 313 million surgeries are performed each year1, and a considerable proportion of patients experience undesirable levels of postoperative pain. A poorly controlled postoperative pain may delay recovery time and the patients may suffer chronic pain that may impair their quality-of-life, causing prolonged duration of opioid use, and higher health-care costs. A US survey showed that 80% of the patients who underwent surgeries experience poorly managed postoperative pain2. Opioids (such as morphine, oxycodone and fentanyl) are the mainstay analgesia for postoperative pain but often associated with side effects such as pruritus, urinary retention, constipation, and respiratory depression, as well as risks of substance abuse. Opioid-involved deaths in the US was 49,860 in 20193 which raised the general public’s concern regarding this issue.

Nalbuphine, a mixed kappa agonist and mu antagonist is developed as an attempt to address opiate-related side effects without the risks involving substance dependence while providing moderate to severe pain relief. Due to its short-acting effect, patients need to be given nalbuphine every 4-6 hours. This may cause blood concentration of nalbuphine to temporarily overshoot the therapeutic window, leading to nausea, dizziness, and vomiting.

1. Nepogodiev D, Martin J, Biccard B, Makupe A, Bhangu A; National Institute for Health Research Global Health Research Unit on Global Surgery. Global burden of postoperative death. Lancet. 2019 Feb 2;393(10170):401. doi: 10.1016/S0140-6736(18)33139-8. PMID: 30722955.
2. Theunissen M, Peters ML, Schepers J, et al. Recovery 3 and 12 months after hysterectomy: epidemiology and predictors of chronic pain, physical functioning, and global surgical recovery. Medicine (Baltimore) 2016;95(26):e3980.
3. Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013–2019. MMWR Morb Mortal Wkly Rep 2021;70:202–207.

How LT1001 can help?

LT1001 is the world's first analgesic injection that offers analgesic effect up to 7 days taking the advantages of nalbuphine. This allows LT1001 to maintain a constant analgesic effect without triggering unwanted side effects while addressing opioid-related issues. LT1001 improves the quality of postoperative care and facilitates rehabilitation to shorten hospital stay.

The API of LT1001, dinalbuphine sebacate (DNS), is a hydrophobic compound containing two nalbuphine molecules joined by sebacoyl ester. The hydrophobic depo environment allows DNS to be slowly released into circulation after IM injection and to be rapidly hydrolyzed by esterases to release nalbuphine. LT1001 produces sustained plasma concentration of nalbuphine by prolonging its half-life, achieving a sustained analgesic effect.

LT1001

Development progress

LT1001 received marketing approval in Taiwan from Taiwan FDA in 2017 and is sold as Naldebain®. LT1001 received approval from Singapore’s HSA, Thailand FDA, Malaysia DCA, Ukraine SMDC and Brunei BDMCA. The development and commercial rights for mainland China and ASEAN countries were granted to Jamincare and AMed, respectively. The registration process is ongoing in Korea and Jordan.
 

Publications

1 Yeh et al., Clin J Pain, 2017 May-33(5)429-434. https://doi.org/10.1097/AJP.0000000000000417

2 Tien et al., Biopharm Drug Dispos, 2017 Nov;38(8):494-497. https://doi.org/10.1002/bdd.2088

3 Feng et al., Taiwan J Pain, 2018;28:22-29. 

4 Huang et al., Asian J Anesth, 2018;56: 74-82. https://doi.org/10.6859/aja.201809_56(3).0002

5 Tsai et al., Trials, 2019;20: 173. https://doi.org/10.1186/s13063-019-3260-4

6 Huang et al., J Med Sci (Taiwan). 2020;40(6):279-283. https://doi.org/10.4103/jmedsci.jmedsci_33_20

7 Wong et al., Taiwan J Pain, 2020;30(1):10-26

8 Lee et al., J Pain Res. 2020;47:2247-2253. https://doi.org/10.2147/JPR.S263315

9 Chang et al., Pain Ther. 2020;2:671-681. https://doi.org/10.1007/s40122-020-00197-x

10 Liu et al., Front Pharmacol. 2021;12:683782. https://doi.org/10.3389/fphar.2021.683782

11 Chang et al., J Pain Res. 2021;14:1763-1771. https://doi.org/10.2147/JPR.S314304

12 Zheng et al., Pain Ther. 2022 Jun;11(2):643-653. https://doi.org/10.1007/s40122-022-00383-z

13 Man et al., Asian J Anesthesiol. 2023;1-7. https://doi.org/10.6859/aja.202305/PP.0001

14 Lee et al., Obes Surg. 2023;33:1192-1201. https://doi.org/10.1007/s11695-023-06502-9

15 Chen et al., J Soc Colon Rectal Surg. 2023;34(1):24-33. https://doi.org/10.6312/SCRSTW.202303_34(1).11129

16 Wong & Sun, Asian J Anesthesiol. 2023;61(3):107-108. https://doi.org/10.6859/aja.202309_61(3).0001

17 Lee et al., Asian J Anesthesiol. 2023;61(3):123-131. https://doi.org/10.6859/aja.202309_61(3).0004

18 Lee et al., Medicine (Baltimore). 2023;102(31):e34423. https://doi.org/10.1097/MD.0000000000034423

19 Li et al., Asian J Anesthesiol. 2023;61(4):183-193. https://doi.org/10.6859/aja.202312_61(4).0005

20 Preda, Front Pharmacol. 2023;14:1181871. https://doi.org/10.3389/fphar.2023.1181871

21 Wang et al., Pharm Basel Switz. 2024;17(1):29. https://doi.org/10.3390/ph17010029

22 Tang et al., J Clin Pharmacol. 2024;64(6), 755–761. https://doi.org/10.1002/jcph.2416

23 Dmytriiev, Emerg Med. 2024;20(5):356-362. https://doi.org/10.22141/2224-0586.20.5.2024.1735

24 Hsieh et al., Formos J Surg. 2025, 58(2), 53–59. https://doi.org/10.1097/FS9.0000000000000154

25 Dmytriiev & Barsa, Emerg Med. 2024;20(7):662-668. https://doi.org/10.22141/2224-0586.20.7.2024.1790

26 Hsu et al., BMC Anesthesiol. 2025;25(1):252. https://doi.org/10.1186/s12871-025-03118-7