Zavegepant Nasal Spray Provides Safe and Effective Acute Treatment of Migraine

In a phase 3 clinical trial (NCT04571060), individuals who used nasal spray zavegepant (Biohaven, New Haven, CT) vs placebo for acute migraine treatment had pain relief as early as 15 minutes after use and were able to return to their normal function as early as 30 minutes after use. In 15.9% vs 8.0% (P<.001) of attacks treated with zavegepant vs placebo, pain relief was experienced 15 minutes after use, and this increased to 43.3% vs 37.3% (P=.029) at 1 hour and 58.7% vs 49.7% (P=.001) at 2 hours.

Pain relief at 2 hours occurred for 23.6% vs 14.9% (P<.001) of migraine attacks treated with zavegepant vs placebo. Freedom from most bothersome symptom, chosen from phonophobia, photophobia, or nausea/vomiting, occurred in 39.6% vs 31.1% of attacks treated with zavegepant vs placebo.

A higher proportion of those treated with zavegepant vs placebo had sustained pain relief for 48 hours (36.1% vs 29.6%; P=.013)

No serious adverse events occurred and the most common mild adverse events with zavegepant vs placebo were dysgeusia (20.5% vs 4.7%), nasal discomfort (3.7% vs 0.8%), and nausea (3.2% vs 1.1%).