Do you ever use Joyrnavx in a patient with end stage liver disease?

I have not encountered this novel oral small molecule medication Suzetrigine for the management of acute moderate to severe pain (FDA approved indication) in my patients with cirrhosis.

The drug received FDA approval in Jan 2025 after two phase III trials where it was used for

• pain control after bunion removal (representing bone pain)
• pain control after abdominoplasty (representing soft tissue pain)

In the phase 3 trials, patients with a history of significant liver disease were excluded (including but not limited to patients with “hepatic cirrhosis, portal hypertension, moderate to severe hepatic impairment defined as Child-Pugh class B or class C”), as well as patients with ALT or AST > 2.5 xULN.

During the pharmacokinetic studies, it ...