Zavegepant Nasal Spray for Treatment of Acute Migraine: A Systematic Review
Victor Ameh Odoma
IU Health, Bloomington, Indiana, USA.
Daniel Nwabueze
Igbinedion University Okada, Edo State, Nigeria.
Benish Alam *
Karachi Medical and Dental College, Pakistan.
Kehinde Tolulope Olaleye
Obafemi Awolowo University, Ile Ife, Nigeria. e Howard University, USA.
Olusayo Louise-Oluwasanmi
Howard University, USA.
Jashanpreet Singh Ballagan
Windsor University School of Medicine, Saint Kitts and Nevis.
Farzana Rahman
Jalalabad Ragib-Rabeya Medical College and Hospital, Bangladesh.
Khudija Nayab
Khyber Girls Medical College, Pakistan.
Akata Abung
College of Medicine, University of Calabar, Nigeria.
Chidera Precious Chukwuneta
Chukwuemeka Odumegwu Ojukwu University, Nigeria.
Oluwaseun Christiannah Sadare
Windsor University School of Medicine, Saint Kitts and Nevis.
Sahar Hassanain
Women Medical College, Pakistan.
Chiugo Okoye
Igbinedion University Okada, Edo State, Nigeria.
Omolola Okunromade
Georgia Southern University, USA.
Uzochukwu Adabanya
Mercer University School of Medicine, USA.
*Author to whom correspondence should be addressed.
Abstract
Background: Migraine is a widespread neurological disorder that can impair quality of life. Current treatments are often insufficient, with side effects causing some patients to seek alternative options. Zavegepant nasal spray, a new treatment being developed for acute migraine, shows promise in blocking the CGRP receptor and providing several potential advantages, such as faster onset of action and higher bioavailability. This systematic review aimed to assess the efficacy and safety of Zavegepant nasal spray in treating acute migraine attacks and identify adverse events.
Methods: Adult patients diagnosed with acute migraine who were treated with Zavegepant nasal spray in randomized controlled trials (RCTs) or non-randomized clinical trials were included. A comprehensive search was conducted in PubMed, Embase, Cochrane Library, and ClinicalTrials.gov until March 2023. The following keywords were employed: "Zavegepant nasal spray", "migraine", "calcitonin gene-related peptide receptor antagonist." A narrative synthesis was conducted to summarize and analyze the extracted data from the included studies, with a focus on the efficacy and safety of Zavegepant nasal spray for the treatment of acute migraine.
Results: This systematic review included three clinical trials, of which two were RCTs, and one was an open-label trial. The total number of participants was 3681, and all of them were in phase 2/3 of testing. The inclusion criteria for these trials were broadly based on individuals who had a history of migraines with or without aura lasting for over a year, which is consistent with the third edition of the International Classification of Headache Disorder. The findings were tabulated and discussed.
Conclusion: Zavegepant nasal spray is an effective and well-tolerated treatment for acute migraines. Further research is needed to confirm its safety and efficacy, optimal dosing and administration, and effectiveness in different populations. The cost-effectiveness, patient satisfaction, and long-term effects on migraine burden ought to be investigated.
Keywords: Zavegepant, nasal spray, acute migraine, neurological disorder