Real-World Effectiveness of Intranasal Zavegepant for Acute Migraine Relief

Patients utilizing intranasal zavegepant, a third-generation calcitonin gene-related peptide (CGRP) receptor antagonist, report significant benefits in managing acute migraines, according to a recent study presented at the 2025 American Headache Society (AHS) Annual Meeting. Conducted by Dr. Eric Dunn, a neurologist at the Cleveland Clinic, this real-world study highlights the drug's potential for rapid pain relief and improved daily functioning among migraine sufferers.

Zavegepant, approved by the U.S. Food and Drug Administration (FDA) in 2023, offers a non-oral treatment option designed for swift action in alleviating acute migraine symptoms. The study involved 99 participants, predominantly female (90%), with a mean age of 46.6 years. Each patient was administered an average of nine doses of the 10-mg intranasal zavegepant. The findings revealed that 45% of patients achieved complete pain relief within two hours at least half the time, suggesting a substantial therapeutic impact.

In addition to pain relief, patients reported improvements in their ability to resume normal activities. Specifically, 60% of participants noted they returned to regular activities at least half the time following the use of zavegepant, while 71.7% felt comfortable planning their daily activities around the medication. These results underscore zavegepant's role in addressing the unpredictability often associated with migraine attacks.

The study utilized the validated Migraine Treatment Optimization Questionnaire-5 (MTOQ-5) to assess patient outcomes. This retrospective analysis is particularly significant as it provides insights into the drug's effectiveness outside of controlled clinical trial settings. According to Dr. Dunn, understanding how zavegepant performs in real-world scenarios is crucial for guiding treatment decisions. The study's outcomes suggest that patients are experiencing meaningful relief and functional improvement with this therapy.

Despite these promising findings, the authors caution that further research is needed to validate the results and explore the long-term implications of zavegepant therapy. "Further real-world follow-up with larger sample sizes are needed to validate these findings," the researchers noted. "Long-term implications of real-world outcomes will help better define the role of zavegepant within the toolbox approach of therapeutics."

Migraine affects nearly 2.81 billion individuals globally, significantly impacting their quality of life. The burden of this condition underscores the importance of effective treatment options. Zavegepant's unique intranasal delivery system allows for rapid absorption, marking it as the first CGRP antagonist available in a nasal spray format. This innovation may be particularly beneficial for those seeking quick relief from acute migraine episodes.

In summary, while zavegepant shows promise as a rapid-acting treatment option for acute migraines, ongoing studies are essential to determine its long-term effectiveness and optimal role in migraine management strategies. The findings add to the growing body of evidence supporting CGRP-targeted therapies in treating migraine disorders, offering hope for improved patient outcomes in the future.