A single dose of a novel antibody medication can bind to fentanyl and prevent the opioid from triggering potentially life-threatening symptoms, research in monkeys suggests
By Grace Wade
5 December 2023
Millions of people in North America have died from a fentanyl overdose
Artur Widak/NurPhoto via Getty Images
A new medication can prevent a high dose of fentanyl from triggering potentially life-threatening symptoms, and the protective effect lasts for almost a month, a study in monkeys shows. If it works in humans, the treatment could be a powerful tool for combatting the opioid epidemic.
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More than 1 million people in the US have died of a drug overdose since 1999. The crisis has largely been fuelled by the proliferation of illicit opioids, most notably fentanyl, which was involved in two-thirds of overdose deaths in 2021. High doses of fentanyl slow respiration, which decreases blood oxygen levels and raises the risk of death.
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“We have an epidemic here in the United States that is almost unprecedented,” says Andrew Barrett at Cessation Therapeutics in San Diego, California. “And we have not been able to stop fentanyl overdose deaths from increasing, so we need new tools.”
As such, he and his colleagues developed a novel antibody therapy – called CSX-1004 – to block the effects of fentanyl. Antibodies are proteins that can destroy pathogens such as bacteria and viruses by binding to molecules on their surface. But instead of targeting disease-causing microbes, the researchers engineered human antibodies to target the fentanyl molecule. “So, [the treatment] does nothing on its own. But if fentanyl is administered, it binds [the opioid] up very quickly and prevents it from getting to the brain,” says Barrett.
He and his team administered 0.032 milligrams of fentanyl per kilogram of body weight – a potentially lethal dose to humans without medical intervention – to four spider monkeys daily for four weeks, which significantly slowed their respiration rate. They then treated the animals with a single intravenous (IV) infusion of CSX-1004 and repeated the dosing experiments for an additional four weeks.