Beth Israel Deaconess Medical Center
The goal of this clinical trial is to learn whether suzetrigine (Journavx®), when added to standard multimodal pain management, can reduce opioid use while providing adequate pain control in adults undergoing surgery for an acute hip fracture. The study will enroll adults aged 18 years or older with femoral neck, intertrochanteric, pertrochanteric, or subtrochanteric hip fractures requiring operative treatment at Beth Israel Deaconess Medical Center. Although enrollment is open to adults aged 18 years and older, the study population is expected to consist predominantly of older adults. The main questions the study aims to answer are: * Does treatment with suzetrigine as part of multimodal pain therapy reduce postoperative opioid consumption, measured as morphine milligram equivalents (MME), during the index hospitalization through 72 hours after surgery or hospital discharge, whichever occurs first? * Does suzetrigine provide effective postoperative pain control and have an acceptable safety and tolerability profile in adults undergoing hip fracture surgery? Researchers will compare participants receiving suzetrigine plus standard multimodal analgesia with matched historical BIDMC patients who underwent similar hip fracture surgery between 2020 and 2025 and received standard multimodal analgesia without suzetrigine. Historical controls will be matched on factors including age, sex, fracture type, surgery type, surgeon, ASA class, opioid-naïve status, regional anesthesia, and relevant comorbidities. Participants in the prospective study will: * Receive a 100-mg oral loading dose of suzetrigine before surgery, followed by 50 mg orally every 12 hours for up to 14 days or until pain resolves, whichever occurs first. * Receive standard multimodal pain management, which may include acetaminophen, nonsteroidal anti-inflammatory medications when appropriate, regional anesthesia, and rescue opioid medication as clinically needed. * Complete pain assessments during hospitalization and at follow-up time points, with opioid use recorded and converted to MME. * Complete follow-up assessments at approximately Days 7, 14, and 28 after surgery, including pain, medication use, adverse events, treatment adherence, and patient-reported outcomes. * Record study medication use, missed doses, rescue opioid use, and adverse events after hospital discharge when applicable.
Hip fracture surgery is frequently associated with substantial acute perioperative pain and a continued need for opioid analgesics. This is particularly important in the predominantly older population affected by hip fracture, in whom opioid exposure may contribute to delirium, respiratory depression, constipation, falls, cognitive impairment, and prolonged opioid use. Although contemporary multimodal analgesic pathways incorporate acetaminophen, nonsteroidal anti-inflammatory drugs when clinically appropriate, regional anesthesia, and opioid rescue medication, there remains a need for effecti…
Inclusion Criteria * Age 18 years or older at the time of surgery. * Acute hip fracture requiring operative treatment, including: * Femoral neck fracture * Intertrochanteric fracture * Pertrochanteric fracture * Subtrochanteric fracture * Treatment with arthroplasty or another operative hip fixation construct at BIDMC. * Acute fracture with injury-to-surgery interval of 14 days or less. * Baseline pain score of 5 or greater on a 0-10 Numeric Rating Scale (NRS) before surgery, indicating moderate-to-severe acute pain. * Ability to self-report pain using the NRS, or, where cognitive impairment…
Suzetrigine is a non-opioid analgesic that selectively inhibits the Nav1.8 voltage-gated sodium channel. Participants will receive a 100 mg oral loading dose followed by 50 mg orally every 12 hours. Treatment may continue for up to 14 days from the first dose or until pain resolves, whichever occurs first. Dose modification or discontinuation may occur when clinically indicated based on hepatic function, concomitant medications, adverse events, or other safety considerations. Suzetrigine is administered in addition to standard multimodal postoperative pain management.