Trevi offers a highly asymmetric, single-asset biotech opportunity: Haduvio could define a new chronic cough market, but the investment case hinges almost entirely on pivotal clinical success.
Overview
Trevi Therapeutics is a clinical-stage biotech focused entirely on Haduvio, a differentiated oral nalbuphine ER candidate for chronic cough in IPF, non-IPF ILD, and refractory chronic cough. The opportunity is significant because these indications have high unmet need and no FDA-approved therapies. Haduvio’s dual kappa-opioid agonist/mu-opioid antagonist mechanism may reduce cough without abuse/dependence concerns or P2X3-related taste disruption. However, Trevi has no revenue, posted a Q1 2026 net loss of $13.2 million, and remains highly dependent on successful late-stage clinical execution.