AHS 2022 | Zavegepant: an acute treatment option for migraine

Richard Lipton, MD, Albert Einstein College of Medicine, New York, NY, discusses zavegepant as an acute treatment option for migraines. There are three FDA-approved gepants for use in migraine: atogepant as a preventive agent, ubrogepant as an acute treatment, and rimegepant as both a preventive agent and acute treatment. Zavegepant is an emerging gepant with a unique administration feature via nasal spray. This gives patients an option over their preferred choice of drug administration. Nasal sprays can allow for a more rapid onset of action due to the mode of administration, and individuals who may struggle with oral therapies could benefit from this. Zavegepant reaches its maximum concentration in the blood in approximately 30 minutes, significantly quicker than the oral gepants currently on the market. The efficacy and safety profile of intranasal zavegepant for the acute treatment of migraine, as compared to placebo, was shown in a randomized controlled Phase II/III trial. In this study, zavegepant showed statistical superiority to placebo on the coprimary endpoints of 2-hour freedom from pain and freedom from a patient’s most bothersome symptom. Additionally, pain relief was investigated at multiple time points – demonstrating a statistically significant difference from placebo in individuals who took the zavegepant nasal spray. Zavegepant demonstrates promising results as an acute migraine treatment option. This interview took place during the 2022 American Headache Society (AHS) Annual Scientific Meeting in Denver, CO.