Trevi Therapeutics jumps on the biotech IPO train

The neurological disease biotech wants $86 million for late-stage trials of its new-look version of an old pain drug. (Nasdaq)

Who isn’t gunning for a biotech initial public offering these days? We thought that maybe after Moderna’s monster raise last year we had reached a peak, but the window remains open, and Trevi is the latest biotech to jump on through.

The eight-year-old New Haven, Connecticut-based company is focused on a series of diseases including chronic pruritus (severe itching), chronic cough in patients with idiopathic pulmonary fibrosis and levodopa-induced dyskinesia in patients with Parkinson’s disease.

These conditions might sound disparate, but the biotech says they share a common pathophysiology, i.e., one that is mediated through opioid receptors in the central and peripheral nervous systems, a target the biotech is going after.  


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The $86 million IPO, should it come off, will go toward its pivotal phase 2b/3 test of nalbuphine ER, in the PRISM trial in patients with severe pruritus associated with prurigo nodularis (a skin disease with itchy nodules).

That drug, nalbuphine ER, is an oral extended release formulation of nalbuphine, a mixed ĸ-opioid receptor agonist and µ-opioid receptor antagonist that has been marketed as an injectable for pain indications for decades.  

Trevi is testing the theory that ĸ- and µ-opioid receptors can be critical mediators of itch, cough and certain movement disorders.

The biotech also stresses, in this environment of opioid abuse, that nalbuphine’s mechanism of action “mitigates the risk of abuse associated with µ-opioid agonists because it blocks µ-opioid receptors,” with nalbuphine the only opioid approved for marketing that is not classified as a controlled substance in the U.S. or Europe.

In the summer of 2017, for its last raise, if got off a $50 million series C, with new investors Lundbeckfonden Ventures, Omega Funds and Aperture Venture Partners along with its largest existing investor, the Californian VC firm TPG Biotech, run by Eran Nadav, Ph.D., which owns more than half of the biotech’s shares.

As part of that funding, biotech veteran David Meeker, M.D., former CEO of Sanofi-Genzyme, became the biotech’s chair (and has a 3.9% stake in the company).

The biotech plans to list on the Nasdaq under the ticker "TRVI."

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