Evidence map›Paper›PMID 41379941›Full record

Trial reportAnesthesiology2026

Respiratory and Antinociceptive Effects of Nociceptin Receptor-µ-Opioid Receptor Agonist Cebranopadol versus Full Opioid Receptor Agonist Oxycodone: A Comparison in Healthy Volunteers.

Simone Jansen, Erik Olofsen, Laurence Moss, Joseph C Grieco, Marc L Lesnick, James C Hackworth, Monique van Velzen, Albert Dahan, Elise Sarton, Geert Jan Groeneveld and 2 more

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Indole Alkaloids as Biased Opioid Receptor Modulators.Pharmaceuticals (Basel, Switzerland) · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Simone JansenSimone Jansen, M.D., Ph.D.: Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-1175-5877
Erik OlofsenErik Olofsen, Ph.D.: Centre for Human Drug Research, Leiden, The Netherlands; Department of Anesthesiology, Leiden University medical Center, Leiden, The Netherlands.
Laurence MossLaurence Moss, M.D.: Centre for Human Drug Research, Leiden, The Netherlands; Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.
Joseph C GriecoJoseph C. Grieco, Ph.D.: Tris Pharma, Inc., Monmouth Junction, New Jersey.
Marc L LesnickMarc L. Lesnick, Ph.D.: Tris Pharma, Inc., Monmouth Junction, New Jersey.
James C HackworthJames C. Hackworth, Ph.D.: Tris Pharma, Inc., Monmouth Junction, New Jersey.
Monique van VelzenMonique van Velzen, Ph.D.: Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Anesthesiology and Pain Medicine, Erasmus MC, Rotterdam the Netherlands.
Albert DahanAlbert Dahan, M.D., Ph.D.: Centre for Human Drug Research, Leiden, The Netherlands; MediD Consultancy BV, Amsterdam, The Netherlands; Outcomes Research Consortium, Houston, Texas.
Elise SartonElise Sarton, M.D., Ph.D.: Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Geert Jan GroeneveldGeert Jan Groeneveld, M.D., Ph.D.: Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands.
Marieke NiestersMarieke Niesters, M.D., Ph.D.: Department of Anesthesiology and Pain Medicine, Erasmus MC, Rotterdam, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands; Departement of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.
Rutger van der SchrierRutger van der Schrier, M.D., Ph.D.: Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe novel analgesic cebranopadol targets the nociceptin (NOP) and µ-opioid (MOP) receptors, acting as a novel full dual NOP-MOP receptor agonist, with possible differences in respiratory effects compared to selective MOP opioids like oxycodone.

methodsIn this randomized, double-blind, placebo-controlled study, 30 healthy volunteers received oral placebo (n = 20), cebranopadol (600 µg, n = 20; 800 µg, n = 20; or 1,000 µg, n = 20), or oxycodone (30 mg, n = 20; or 60 mg, n = 20) on four occasions in a partial crossover design. On each occasion, measures of ventilation at an extrapolated isohypercapnic level of 55 mmHg derived from hypercapnic ventilatory responses and electrical pain tolerance tests were obtained at regular intervals before and for 24 h after drug intake. Mixed model analyses on respiratory endpoints were performed (primary endpoint) as well as an exploratory population pharmacokinetic/pharmacodynamic analysis on respiratory and analgesic endpoints.

resultsOxygen desaturations (to approximately 80%) were observed in 65% of subjects after oxycodone 60 mg versus cebranopadol 1,000 µg in 25% of subjects (all occurring when experimental respiratory or pain testing was not performed). A significant main effect and a significant separation of all cebranopadol and oxycodone doses versus placebo (all P < 0.0001) was observed with cebranopadol 600 µg producing less respiratory depression than oxycodone 30 mg ( P = 0.022). Pharmacokinetic/pharmacodynamic analyses showed that the respiratory drug concentration causing 50% effect was 0.20 ± 0.54 ng/ml for cebranopadol versus 36 ± 6 ng/ml for oxycodone (values are median ± standard error of the estimate). Cebranopadol was more potent than oxycodone in producing analgesia.

conclusionsThe primary endpoint showed separation between the respiratory effects of cebranopadol and oxycodone, with 25% less respiratory depression at equianalgesia, as observed in the pharmacokinetic/pharmacodynamic analysis.

Indexed as

Analgesics, OpioidIndolesOxycodoneReceptors, OpioidReceptors, Opioid, muRespirationSpiro CompoundsAdultCross-Over StudiesDose-Response Relationship, DrugDouble-Blind MethodFemaleHealthy VolunteersHumansMaleNociceptin Receptor((3-methoxythiophen-2-yl)methyl)((2-(9-(pyridin-2-yl)-6-oxaspiro(4.5)decan-9-yl)ethyl))amine6'-fluoro-4',9'-dihydro-N,N-dimethyl-4-phenylspiro(cyclohexane-1,1'(3'H)-pyrano(3,4-b)indol)-4-amineAnalgesics, OpioidIndolesNociceptin ReceptorOxycodoneReceptors, OpioidReceptors, Opioid, muSpiro CompoundsThiophenes

Identifiers

PMID41379941
PMCPMC12965820

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.