Trevi Therapeutics (TRVI) Stock Price, News & Analysis

Trevi Therapeutics, Inc. (Nasdaq: TRVI) is a clinical-stage biopharmaceutical company focused on developing Haduvio™ (oral nalbuphine extended-release) as an investigational therapy for chronic cough conditions. According to the company’s disclosures, Haduvio is being studied for the treatment of chronic cough in adults with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC). The company states that Haduvio is the first and only investigational therapy to show a statistically significant reduction in cough frequency in clinical trials in both IPF chronic cough and RCC patient populations.

Trevi Therapeutics describes Haduvio as an oral extended-release formulation of nalbuphine that acts on the cough reflex arc both centrally and peripherally as a kappa agonist and mu antagonist (KAMA). This mechanism targets opioid receptors that the company indicates play a key role in controlling chronic cough. Nalbuphine is described in the company’s materials as not currently scheduled by the U.S. Drug Enforcement Agency. Trevi also notes that Haduvio’s proposed trade name and its safety and efficacy have not been evaluated or approved by any regulatory authority.

Focus on chronic cough in IPF and interstitial lung disease

The company highlights chronic cough in patients with IPF and non-IPF ILD as areas of high unmet medical need. Trevi cites estimates of approximately 150,000 IPF patients in the United States, with a substantial proportion experiencing uncontrolled chronic cough, and approximately 228,000 U.S. patients with non-IPF ILD, many of whom also have uncontrolled chronic cough. The company’s disclosures emphasize that there are no FDA-approved therapies for chronic cough in these populations and that off-label treatment options provide limited benefit.

Trevi reports that chronic cough in these conditions can be severe, with patients coughing up to 1,500 times per day. The company associates this persistent cough with potential worsening of underlying disease, higher risk of progression, increased respiratory hospitalizations, and a decline in quality of life, including social, physical, and psychological impacts. These disease characteristics underpin Trevi’s focus on specialty indications in chronic cough.

Refractory chronic cough (RCC) program

In addition to IPF and non-IPF ILD chronic cough, Trevi is developing Haduvio for refractory chronic cough. The company describes RCC as a persistent cough lasting more than eight weeks despite treatment of underlying conditions such as asthma, gastroesophageal reflux disease, non-asthmatic eosinophilic bronchitis, upper airway cough syndrome, or post-nasal drip, and notes that RCC includes unexplained chronic cough. Company materials estimate that RCC affects roughly 2–3 million patients in the United States and is believed to be associated with cough reflex hypersensitivity involving both central and peripheral nervous systems.

Trevi characterizes RCC as highly debilitating, with physical, psychological, and social consequences. The company notes that there are no FDA-approved therapies for RCC and that the condition can lead to complications such as sleep disruption and social and economic burdens for patients and those around them. These factors frame RCC as another key target indication for Haduvio.

Clinical development of Haduvio

Trevi’s clinical development program for Haduvio includes multiple trials in chronic cough related to IPF and RCC. The company reports positive topline results from its Phase 2b CORAL trial (Cough Reduction in IPF with Nalbuphine ER) in patients with IPF chronic cough. According to Trevi, this double-blind, randomized, placebo-controlled, parallel-arm study evaluated three doses of nalbuphine ER (27 mg, 54 mg, and 108 mg twice daily) versus placebo over a 6-week treatment period and met its primary endpoint of relative change in 24-hour cough frequency compared with placebo.

Trevi also describes the Phase 2a RIVER trial (Refractory Chronic Cough Improvement Via Nalbuphine ER), a randomized, double-blind, placebo-controlled, two-period crossover study in RCC patients. Each treatment period lasted 21 days, separated by a 21-day washout, with titration through multiple doses of nalbuphine ER. The primary endpoint was mean change in 24-hour cough frequency at Day 21. The company has highlighted statistically significant reductions in cough frequency in RCC clinical trials and has presented RIVER data at scientific meetings, including the European Respiratory Society Congress and the CHEST Annual Meeting.

In its updates, Trevi notes additional studies supporting the Haduvio program, including a Phase 1 respiratory function and safety study in patients with IPF (referred to as TIDAL) and a Phase 1 drug–drug interaction study evaluating nalbuphine ER co-administered with standard-of-care antifibrotic therapies pirfenidone or nintedanib. The company reports that the drug–drug interaction study showed no clinically meaningful pharmacokinetic findings for nalbuphine ER or the antifibrotics when given in combination.

Regulatory and development pathway

Trevi’s public communications describe a development path that includes End-of-Phase 2 interactions with the U.S. Food and Drug Administration (FDA) for chronic cough in IPF. The company reports that it has been granted an End-of-Phase 2 meeting by the FDA to discuss the clinical development and regulatory pathway for a potential New Drug Application for nalbuphine ER in chronic cough in IPF. Trevi has stated its intention to initiate a Phase 3 program in this patient population following these regulatory discussions and has also indicated plans for a Phase 2b trial in RCC.

Throughout its disclosures, Trevi emphasizes that Haduvio remains an investigational therapy and that its safety and efficacy have not been evaluated or approved by any regulatory authority. Statements regarding future clinical plans and regulatory milestones are characterized by the company as forward-looking and subject to risks and uncertainties described in its SEC filings.

Disease burden and unmet need

Trevi repeatedly underscores the unmet medical need in chronic cough associated with IPF, non-IPF ILD, and RCC. The company notes that patients may cough hundreds to thousands of times per day and that this burden can contribute to morbidity, including worsening disease, higher risk of progression, and increased respiratory hospitalizations. The company also highlights the impact on quality of life, including social embarrassment, sleep disruption, and psychological distress.

By focusing on these indications, Trevi positions its development efforts within a segment of respiratory and cough-related disorders where, according to its statements, no FDA-approved therapies are currently available. The company’s clinical data presentations at conferences such as CHEST and the European Respiratory Society Congress are used to communicate trial results and patient-reported outcomes to the medical and scientific community.

Public company and regulatory reporting

Trevi Therapeutics, Inc. is incorporated in Delaware and files reports with the U.S. Securities and Exchange Commission (SEC) as a public company. The company has furnished current reports on Form 8-K to disclose quarterly financial results and material corporate events, including changes in senior financial leadership. These filings reference press releases that provide additional detail on clinical progress, financial position, and corporate strategy. Through its SEC filings, Trevi outlines risks related to clinical development, regulatory review, financing, and other factors that could affect its business and the development of Haduvio.

Key points for TRVI stock watchers

• Clinical-stage biopharmaceutical company focused on chronic cough indications in IPF, non-IPF ILD, and RCC.
• Lead investigational therapy Haduvio (oral nalbuphine ER) has shown statistically significant reductions in cough frequency in IPF chronic cough and RCC clinical trials, according to company reports.
• Development program includes Phase 2b CORAL and Phase 2a RIVER trials, as well as Phase 1 safety and drug–drug interaction studies.
• Company highlights the absence of FDA-approved therapies and significant quality-of-life impact in targeted chronic cough populations.
• As a Nasdaq-listed issuer, Trevi reports clinical, financial, and corporate updates through press releases and SEC filings.