What Happened

Trevi Therapeutics initiated two clinical trials in Q2 2026: Phase 3 OCEAN-1 for IPF-related chronic cough and Phase 2b LAKE for refractory chronic cough. The company bolstered its cash position to $318.9M after a $162.3M equity offering, funding operations through 2030.

Who Is Affected

This impacts 2–3M U.S. patients with chronic cough across three indications: IPF, non-IPF ILD, and refractory cases. Trevi's management emphasized the unmet need, with no FDA-approved therapies currently available.

Market Impact

• First-mover advantage in chronic cough with Phase 3 data expected by 2027
• Pipeline prioritizes IPF (Phase 3) over refractory cough (Phase 2b)
• Cash runway excludes commercial launch, indicating future capital needs

What to Watch

Key milestones include FDA meeting on non-IPF ILD plans in Q4 2026 and LAKE trial sample-size re-estimation. Commercial teams should track OCEAN-2 Phase 3 initiation in Q3 2026 as a validation signal.

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