Our Mission & Approach
Nirsum aims to solve the key efficacy hurdles of existing addiction treatments including therapeutic retention, strength, safety, and access.
OUD
Currently, the OUD treatment market is divided into two main segments: “opioid replacement” and “abstinence”. Opioid replacements strategies utilize DEA scheduled and approved opioid agonists medications like buprenorphine and methadone, which reduce overdose risk and morbidity versus continued illicit use; however, continued indefinite opioid dependence is necessary using this treatment strategy. NRS-033 differs from this approach. It is instead intended for patients no longer wanting indefinite opioid dependence, who are seeking opioid abstinence.
Abstinence-based treatments typically involve opioid detoxification in rehabilitation programs, followed by intensive psychosocial counseling and peer support. The goal is to curatively decay over time the unhealthy habits and cues associated with opioid addiction by changing its associated people, places and things. The only FDA-approved medication to prevent relapses during this long-term recovery phase after detoxification phase is opioid antagonist naltrexone. However, oral naltrexone has median therapeutic retention of just a few days. Injectable extended-release naltrexone fares better but has a median retention of just ~28 days. As a result, naltrexone is not perceived as effectively supporting abstinence, so is used in ~5% of indicated OUD patients. In the absence of medication, relapse rates in abstinence seeking OUD patients are as high as 91%.
AUD
Naltrexone is the primary medication used in AUD. In AUD, naltrexone can facilitate alcohol abstinence but functions more often to reduce heavy drinking to safer levels. As with OUD, naltrexone is best used with concurrent psychosocial counseling and/or peer support, to help address the issues underlying the addiction. However, naltrexone’s (in both forms) median retention is short in AUD at an estimated median of just days to weeks, limiting actual efficacy. Two other medications are also approved in AUD – daily oral acamprosate (approved in 2004) and disulfiram (approved in 1951) – both unpopular and limited by non-adherence, poor efficacy, and side effects. Given these limitations, in aggregate, medications for AUD are used in <2% of indicated patients. Reported relapse rates for recovery-seeking AUD patients are as high as 60%.
NRS-033
NRS-033 aims to significantly overcome the major shortcomings of naltrexone in OUD and AUD, by improving efficacy-limiting therapeutic retention, therapeutic effect, safety, and patient accessibility.