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Stock Ratings / Health Care / TRVI / options
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Trevi Therapeutics Inc. (TRVI) Options Positioning, Max Pain & Unusual Sweeps

$13.63 +0.52% NASDAQ • Live Quote vs Prior Daily Close (Synced Snapshot) EXT / AFTER-HRS: $13.62

Trevi Therapeutics Inc. (TRVI) carries a Roarable Rating of E (Strong Sell) with 30/100 RQD Confidence due to weak cash-flow efficiency and sensitivity to current interest rates. Wait for business cash flow and institutional buying to improve before committing fresh capital.

ROARABLE E • RED ALERT Cap $1.93B
📤 Share Live RQD Speedometer Card: 𝕏 Post Reddit StockTwits ⬇ Live SVG Card
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🤖 Mara Quenwick • AI Quant Lead (Click for Instant Brief) Is TRVI stock a Buy, Hold, or Sell right now according to Roarable's RQD model?
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As of 2026-11-03, Trevi Therapeutics Inc. (NASDAQ: TRVI) is rated E (Strong Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 30/100 at a spot price of $13.63 (+0.52% 1D, market cap $1.93B). Pillar breakdown: Fundamental Cash Engine 4/20, Institutional 13F & Options Flow 7/20, SEC Balance-Sheet Forensics 10/20, FRED Macro Regime Fit 6/20, and Executive Insider Alignment 3/20. Across 1015 tracked Health Care issuers, TRVI ranks #785 in composite RQD confidence.

✓ Pre-computed one-to-many AI Quant brief
🤖 Ellis Vennor • AI Peer & Flow Quant (Click for Instant Brief) How does TRVI compare to BRVE and XERS in the Health Care sector?
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Within the Health Care sector (Biotechnology: Pharmaceutical Preparations), TRVI carries a Roarable E (30/100 RQD), trailing P/E of N/A, gross margin of —, and ROIC of -23.7%. By comparison, BRVE (Braveheart Bio Inc.) holds a D grade (46/100 RQD, P/E N/A, ROIC —, cap $1.94B) and XERS (Xeris Biopharma Holdings Inc.) posts a C grade (64/100 RQD, P/E N/A, ROIC 16.0%, cap $1.95B). Among the 5-stock peer group, TRVI leads on earnings multiple (N/A) while XERS leads on capital efficiency (16.0% ROIC).

✓ Pre-computed one-to-many AI Quant brief
🤖 Gideon Ashmere • AI SEC 10-K Forensics (Click for Instant Brief) What are the biggest fundamental strengths and SEC risk factors for TRVI?
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Per TRVI's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001563880), Trevi Therapeutics Inc. generated $138.1M in revenue (-4.3% YoY), -$42.8M in net income, and -$42.1M in free cash flow against $193.4M in total assets and $0 in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately. Institutional options positioning shows a 50% call / 50% put premium split.

✓ Pre-computed one-to-many AI Quant brief
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INTERACTIVE SCENARIO DECK:
🛡️ Portfolio Crash X-Ray
EXT / AFTER-HRS: $13.62 (-0.10%)🧬 Dilution Drag (+2.48% YoY Shares)⚙️ Cash Engine: 4/20 (E) • 0% FCF Margin
Verify 90D Bucket Audit →
📊 Historical Track Record Warning: Scores below 50 (30/100 · E) historically underperformed SPY in 71% of rolling 90-day windows (-9.6% avg 90D alpha vs SPY • 29.0% hit rate).
Audit Bucket Track Record →
RQD QUANT TACHOMETERRED ALERT • E
025507510030
3-of-3 JEV AI Jury Bearish Warning
Cash
SEC
Whale

Impersonal quantitative research (0–100 RQD rubric) — not individualized investment advice. Past performance does not guarantee future results. Full Disclaimer

5-PILLAR SNOWFLAKE RADARRw E · Rk D-
Cash (4)Whales (7)SEC (10)Macro (6)CEO (3)
Each axis scored 0–20
12M PRICE TARGET CONE-12.6% Base Target
$21 Bull$12 Base$9 Bear
📬 FREE TRVI RATING-CHANGE & BRIEFING ALERTSManage / Unsubscribe
WHALE OPTIONS SNAPSHOT: — (No Active Options Snapshot on file for TRVI)Realized 20D OHLCV Swing Band: ±10.4%
Deterministic 5-Pillar Attribution (30/100 Composite)
🔍 WHY TRVI SCORES 30/100 (E) — TOP 3 DRIVERS2 Bullish Pillars + #1 Risk Drag
▲ #1 Bullish Driver: SEC 10-K Forensic Risk+10/20 pts (33% of score)

Altman Z-Score 3.80 (FORTRESS SAFE (>3.0)) • Piotroski F-Score 3/9

▲ #2 Bullish Driver: Whale & Options Positioning+7/20 pts (23% of score)

20D Institutional Volume Accumulation (±10.4% realized swing band)

▼ #1 Drag / Risk Factor: Insider Conviction & Share Dilution4/20 pts (-16 pt drag)

Dilution Drag (+2.48% YoY Shares) & executive Form 4 sales trim 16 pts from alignment

📈 PAST 4 QUARTERS RQD vs SUBSEQUENT RETURNQ1 → Q2 → Q3 → Current
Q1 (-3Q)
22
Grade E$12.29+4.4% Next Q
Q2 (-2Q)
25
Grade E$12.83+4.1% Next Q
Q3 (-1Q)
27
Grade E$13.35+2.1% Next Q
Current
30
Grade E$13.63-9.6% Hist 90D α
Trajectory: E (22) → E (30)Full Audit →
⚔️ ADVERSARIAL OPPOSING CASE & FORENSIC KILL-SWITCH (WHY THE BULL/BEAR THESIS COULD FAIL)CONTRARIAN TURNAROUND & SHORT-SQUEEZE DOSSIER

⚔️ Adversarial Opposing Case: What Could Spark a TRVI Turnaround Squeeze

Gideon Ashmere Forensic Desk →

While TRVI currently carries a cautious 30/100 (E) rating due to Insider Conviction & Share Dilution (4/20), shorts face asymmetric squeeze risk if free cash flow inflects or management executes accretive buybacks.

🚀 Contrarian Squeeze Trigger #1

Established market leader in Health Care with deep daily trading liquidity.

🚀 Contrarian Squeeze Trigger #2

Options & Short-Covering Gamma: Reclaiming the 50-day SMA ($14.52) and Max Pain ($14.31) forces dealer call-delta covering toward $21.23.

🚀 Contrarian Squeeze Trigger #3

Forensic Repair Trigger: Halting share dilution (Dilution Drag (+2.48% YoY Shares)) or retiring high-cost debt immediately upgrades the SEC 10-K Forensic pillar.

🎲 LIVE PREDICTION MARKET ODDS TIED TO $TRVI• $2.4M Crowd Pool • Kalshi / Polymarket Composite
Contract: “TRVI Beats Next Quarter EPS Consensus (Dec 30, 2026) & Holds Above 200D SMA”
YES 30%NO 70%Trade / Inspect Odds →
CALL VS. PUT WHALE SHARE
— (No Active Options Snapshot)
Put/Call Ratio: — (No Active Options Snapshot)
MAX-PAIN EXPIRATION MAGNET
— (No Active Options Snapshot)
No active options chain max-pain snapshot on file
HISTORICAL 20D VOLATILITY SWING
±10.4%
Derived from 20D OHLCV bars (No Active Options Snapshot)

Active Strike Call vs. Put Concentration Ladder (TRVI)

— (No Active Options Snapshot) — No unusual CBOE strike concentration anomalies recorded in the current database snapshot for TRVI.

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Red-Light Warning Desk: Spotting SEC Cash-Flow & Dilution Risks Before Downgrades (Featuring TRVI)

  • ✓Walkthrough of TRVI's RQD Radar, SEC cash-conversion gap & downside invalidation levels
  • ✓3 asymmetric Bear/Hedge frameworks when 10-year Treasury yields stay elevated
  • ✓Includes nightly RQD rating-change & forensic signal email alerts on your tracked stocks
RQD INSIDER CLUB WAITLIST$49/YR PLANNED
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TRVI // CANDLESTICK & AUTO-TRENDLINE WORKSTATION6M: -5.22%▼ DESCENDING CHANNEL
2026-11-03O $13.81H $13.81L $13.56C $13.63VOL 1.73M
RES: $17.85SUP: $10.89SMA50: $14.52SMA200: $14.37
$20.88$18.13$15.38$12.62$9.87RES $17.85SUP $10.89$13.632026-05-042026-06-172026-08-042026-09-182026-11-03
PRIMARY-SOURCE FORENSICS, SECOND-ORDER LINKS & AI ANALYST DESK

TRVI Dilution Monitor, Expectations Hurdle, Butterfly Connections & Policy Exposure

🦋 TRVI Butterfly Map → + Track TRVI →
Share Count & Dilution Monitor

Multi-year comparable XBRL diluted share count not disclosed (ETF or recent listing).

Reverse-DCF Expectations Hurdle
8.0%/yr Implied 5Y Growth

vs. -4.3% actual YoY revenue growth (assuming 9.25% cost of equity & 16.5x terminal multiple).

Ellis Vennor Setup Ledger

No active Ellis Vennor swing setup published on TRVI today. View full Setup Ledger →

🦋 Documented & Second-Order Butterfly Connections Open Graph →

No direct multi-tier Butterfly edges indexed yet for TRVI. Explore sector supply chains on /butterfly.

AI Analyst Theses, Washington Policy & Company Video
🎬 No recent verified company-specific video clip queued for TRVI today (we never pad ticker pages with unrelated generic clips). Browse Macro Video Desk →
DETERMINISTIC MULTI-FACTOR EQUITY AUDIT • SEC EDGAR XBRL × RQD PEER BENCHMARK

📊 Quantitative Sector Peer Comparison, SEC Filing Delta & Investment FAQ (TRVI)

Health Care Rank #785 of 1015 ⚔️ BRVE vs TRVI Full Matrix →

1. Head-to-Head Health Care Peer Comparison (TRVI vs. BRVE, XERS, SLS, SRPT)

Industry: Biotechnology: Pharmaceutical Preparations (489 Tracked Issuers)

Across 1015 tracked Health Care securities in the Roarable RQD universe, Trevi Therapeutics Inc. (TRVI) ranks #785 by composite RQD confidence (30/100, grade E) and #263 by equity capitalization ($1.93B). Within this direct 5-issuer industry benchmark cohort, TRVI leads on earnings valuation at N/A trailing P/E, while XERS leads on capital efficiency and profitability with 16.0% ROIC and — gross margin. XERS currently holds the highest overall quantitative score in the immediate peer group at 64/100 (C) compared with TRVI at 30/100 (E).

Ticker / Company Roarable Grade RQD Score Trailing P/E Gross Margin ROIC 1D Change Market Cap Head-to-Head
TRVI ACTIVE
Trevi Therapeutics Inc.
E 30/100 — — -23.7% +0.52% $1.93B Benchmark Subject
BRVE
Braveheart Bio Inc.
D 46/100 — — — -2.18% $1.94B /brve-vs-trvi →
XERS
Xeris Biopharma Holdings Inc.
C 64/100 — — 16.0% -5.04% $1.95B /xers-vs-trvi →
SLS
SELLAS Life Sciences Group Inc.
D- 38/100 — — -21.8% -11.67% $1.95B /sls-vs-trvi →
SRPT
Sarepta Therapeutics Inc.
E 27/100 — 96.0% -35.0% -1.61% $1.97B /srpt-vs-trvi →

2. Multi-Year SEC XBRL Revenue, Cash Flow & Balance-Sheet Trajectory (FY2023–FY2025)

SEC EDGAR 10-K • FILED 2025-12-31 • CIK 0001563880 ↗

In its most recent audited fiscal period (FY2025, filed 2025-12-31), Trevi Therapeutics Inc. (TRVI) reported GAAP revenue of $138.1M (-4.3% vs. FY2024 revenue of $144.3M , and +45.4% cumulative change since FY2023) , GAAP net income of -$42.8M, operating cash flow of -$42.1M, and free cash flow of -$42.1M (-10.0% YoY). On the balance sheet, TRVI closed FY2025 with $193.4M in total assets against $0 in total debt (Altman Z-Score: N/A, Piotroski F-Score: 3/9).

Fiscal Period Filing Date Revenue Net Income Operating Cash Flow Free Cash Flow Total Assets Total Debt
FY2025 (FY) 2025-12-31 $138.1M -$42.8M -$42.1M -$42.1M $193.4M —
FY2024 (FY) 2024-12-31 $144.3M -$47.9M -$38.3M -$38.3M $110.9M —
FY2023 (FY) 2023-12-31 $95.0M -$29.1M -$31.7M -$31.7M — —

3. TRVI Data-Verified Investor FAQ (RQD Rating, Sector Peers, SEC Forensics & Technicals)

✓ SCHEMA.ORG FAQPAGE JSON-LD ENABLED

Is TRVI stock a Buy, Hold, or Sell right now according to Roarable's RQD model?

As of 2026-11-03, Trevi Therapeutics Inc. (NASDAQ: TRVI) is rated E (Strong Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 30/100 at a spot price of $13.63 (+0.52% 1D, market cap $1.93B). Pillar breakdown: Fundamental Cash Engine 4/20, Institutional 13F & Options Flow 7/20, SEC Balance-Sheet Forensics 10/20, FRED Macro Regime Fit 6/20, and Executive Insider Alignment 3/20. Across 1015 tracked Health Care issuers, TRVI ranks #785 in composite RQD confidence.

How does TRVI compare to BRVE and XERS in the Health Care sector?

Within the Health Care sector (Biotechnology: Pharmaceutical Preparations), TRVI carries a Roarable E (30/100 RQD), trailing P/E of N/A, gross margin of —, and ROIC of -23.7%. By comparison, BRVE (Braveheart Bio Inc.) holds a D grade (46/100 RQD, P/E N/A, ROIC —, cap $1.94B) and XERS (Xeris Biopharma Holdings Inc.) posts a C grade (64/100 RQD, P/E N/A, ROIC 16.0%, cap $1.95B). Among the 5-stock peer group, TRVI leads on earnings multiple (N/A) while XERS leads on capital efficiency (16.0% ROIC).

What are the biggest fundamental strengths and SEC risk factors for TRVI?

Per TRVI's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001563880), Trevi Therapeutics Inc. generated $138.1M in revenue (-4.3% YoY), -$42.8M in net income, and -$42.1M in free cash flow against $193.4M in total assets and $0 in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately. Institutional options positioning shows a 50% call / 50% put premium split.

Where is TRVI trading relative to its 50-day, 200-day, and 52-week technical levels?

TRVI last traded at $13.63 (+0.52% on volume of 1,472,025 shares), positioning the stock -6.13% below its 50-day simple moving average ($14.52) and -5.15% below its 200-day simple moving average ($14.37). Across its 52-week range of $9.82 to $20.22, TRVI sits at the 36.6% percentile with a 14-day RSI of 50.4 (NEUTRAL RANGE) and an implied next-earnings move of ±10.4% ($12.21 to $15.05).

Direct Sub-Reports: TRVI RQD Cockpit TRVI 12M Forecast TRVI Earnings & Move TRVI Dividends & DRIP TRVI Insiders & 13F TRVI Whale Options TRVI Profit Sankey TRVI News & Why
ROARABLE RATING BRIEF • RQD 30/100 (E) ✓ SEC XBRL & RQD VERIFIED

TRVI — Trevi Therapeutics Inc.: What the Facts Mean to a Prospective Investor

Methodology: RQD v6.2 Deterministic 5-Pillar & SEC XBRL Audit
Updated: 2025-12-31

1. Roarable Rating Brief: What This Means to a Prospective Investor

Trevi Therapeutics Inc. (TRVI) earns a live Roarable RQD composite score of 30/100, corresponding to a E letter grade (Roarable Strong Sell) at a spot price of $13.63 (+0.52% 1D, market capitalization $1.93B).

  • Fundamental Cash Engine (4/20): Anchored by return on invested capital (ROIC) of -23.7%, gross margin of —, operating margin of —, and free cash flow yield of -2.14%.
  • Whale 13F & Options Flow (7/20) + Insider Conviction (3/20): Tracks institutional 13F accumulation, CBOE options call/put positioning, and SEC Form 4 / Congressional PTR filings.
  • Macro Regime Fit (6/20) + Forensic Balance Sheet (10/20): Incorporates a 1.00x equity beta, Altman Z-Score of N/A, Piotroski F-Score of 3/9, and Debt/Equity of N/A.

2. Business Model, Unit Margins & SEC Financial Trajectory

Trevi Therapeutics Inc. Is a NASDAQ-listed issuer in the Health Care sector, operating within the Biotechnology: Pharmaceutical Preparations industry..0B. Reported revenue is — across the available periods, so the company's commercial monetization is not evident in the reported financials.

In its latest audited SEC EDGAR 10-K filing for FY2025 (filed 2025-12-31), Trevi Therapeutics Inc. (TRVI) reported $138.1M in annual revenue (up from $144.3M in FY2024, -4.3% YoY) and -$42.8M in GAAP net income. Over the multi-year SEC filing window from FY2023 ($95.0M revenue, -$29.1M net income) through FY2025, TRVI scaled operating cash flow to -$42.1M and free cash flow to -$42.1M, backed by $193.4M in total assets against $0 in total debt.

3. Institutional Bull vs. Bear Thesis & Valuation Tradeoff

  • 🐂 Primary Bull Case (E • RQD 30/100): Established market leader in Health Care with deep daily trading liquidity. Free cash flow yield of -2.14% and institutional whale pillar of 7/20. With Fundamental Cash Engine at 4/20 and Institutional Whale Flow at 7/20, sustained execution supports upside toward the upper end of the $9.82 – $20.22 52-week range.
  • 🐻 Primary Bear Case & Valuation Risk: Company executives have done more routine share selling than personal cash buying lately. Investors must weigh current valuation against — operating margins and a 1.00x macro beta.

4. 2nd-Order Butterfly Ripples & Key Questions to Watch

Sector correlations beyond the beta of 1. The main ripple a prospective investor should watch is the company's dependence on its clinical-stage pipeline, as indicated by the news wire's trial and partnership references, since a shift in those programs would transmit directly to cash burn and valuation.

  • Key Question #1: Can TRVI sustain or expand its — operating margin and -23.7% ROIC against Biotechnology: Pharmaceutical Preparations peers over the next 4 quarters?
  • Key Question #2: Following FY2025 revenue of $138.1M and free cash flow of -$42.1M, how will capital allocation balance growth reinvestment against $0 in total debt?
  • Key Question #3: How sensitive is TRVI's equity valuation to Health Care capital spending cycles and macro interest-rate shifts (Beta 1.00x)?

TRVI Live News Feed, Press Releases & Catalyst Wire

Real-time company headlines, analyst actions, and sector developments for Trevi Therapeutics Inc. (TRVI) • Click "Debate This Headline" to argue it in the Roar Pit below

💬 Jump to TRVI Debate Forum (3) ↓
🔥 THE ROAR PIT • LIVE COMMUNITY DEBATE 3 Active Posts & Replies

TRVI Bull vs. Bear Conversation Board — What's Your Call at $13.63?

🐂 67% BULLISH CONVICTION COMMUNITY TUG-OF-WAR ON TRVI 🐻 33% BEARISH CONVICTION
1. Pick Your Side on TRVI:
💡 Tip: Back up your call with a price target or RQD metric to get upvoted to the top.
TA TapeReader_Pro RQD DEBATE OPENER • Price Action & Volume Trader 🐂 BULLISH 🎯 Target: $17.09 (+26.0%)
📌 Pinned Debate

Early reports of sustained improvement in a chronic-cough trial could support a re-rating if the data holds.

Long TRVI at $13.56 targeting $17.09. Early reports of sustained improvement in a chronic-cough trial could support a re-rating if the data holds.. Institutional whale score is 7/20 and the risk/reward vs. the $9.82 52-week low is skewed heavily in favor of bulls.

ArenaChamp_24 🐂 BULL

@TapeReader_Pro Agree on the RQD 30/100 quality, though with 1.0 beta I'm scaling in with half-size at $13.56 and keeping dry powder in case we test $12.61.

SK SkepticalCFA RQD DEBATE OPENER • Fundamental Contrarian 🐻 BEARISH 🎯 Target: $11.25 (-17.0%)
Spot @ $13.56

Zero reported revenue alongside a -$42.1M FY 2025 free cash flow and a cash balance that fell to $18.9M leaves limited runway.

Fading this rally in TRVI at $13.56. Zero reported revenue alongside a -$42.1M FY 2025 free cash flow and a cash balance that fell to $18.9M leaves limited runway.. With a beta of 1.0 and the stock sitting at $13.56 (52-wk range $9.82–$20.22), the easy multiple expansion is already priced in.

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