Intranasal Zavegepant Achieves Rapid Pain Freedom in 63% of Migraine Patients in Real-World Use
Background
Migraine is a debilitating neurological disorder characterized by severe headaches and associated symptoms, significantly impacting quality of life. Traditional acute treatments often have limitations, including slow onset of action, systemic side effects, or contraindications. The discovery of calcitonin gene-related peptide (CGRP) as a key mediator in migraine pathophysiology led to the development of novel antagonists. Gepants, like zavegepant, offer a targeted, non-opioid approach by blocking the CGRP receptor, providing a crucial alternative for acute migraine management, especially for patients requiring rapid relief or experiencing nausea.
Study Design
This single-center, descriptive, cross-sectional survey study retrospectively analyzed real-world outcomes for patients prescribed 10 mg intranasal zavegepant at the Cleveland Clinic. Data were collected from 60 eligible patients who used at least two doses, identified between July 2023 and December 2024. Surveys administered from January to March 2025 included the Migraine Treatment Optimization Questionnaire-5 (MTOQ-5) and additional questions assessing dosage frequency, pain freedom, freedom from most bothersome symptom, and willingness to reuse.
Results
Among the 60 patients, 27 of 60 (45%) reported achieving pain freedom within 2 hours for half or more of their attacks. A significant 38 of 60 (63%) patients reported pain freedom within 2 hours after zavegepant administration, with 10 of 60 (17%) achieving pain freedom within 30 minutes.
One dose of zavegepant relieved headache for at least 24 hours in 26 of 60 (43%) patients, half the time or more. Furthermore, 36 of 60 (60%) patients reported being able to return to normal activities after using
zavegepant.
Key Findings
- 63% of patients reported pain freedom within 2 hours after
zavegepantuse. - 17% of patients achieved pain freedom within 30 minutes of
zavegepantadministration. - 45% of patients reported pain freedom within 2 hours for half or more of their attacks.
- 43% of patients experienced headache relief for at least 24 hours half the time or more.
- 60% of patients reported being able to return to normal activities after
zavegepantuse.
Why It Matters
This real-world data reinforces the clinical utility of zavegepant as an acute migraine treatment, demonstrating its rapid efficacy outside of controlled trial settings. For individuals seeking quick relief from migraine attacks, particularly those with nausea or difficulty swallowing oral medications, intranasal zavegepant offers a highly effective and convenient option. The high rates of pain freedom and return to normal activities suggest a significant improvement in acute migraine management, potentially reducing disability days and improving patient quality of life. This supports its integration into diverse treatment protocols.
zavegepant
migraine
cgrp-antagonist
real-world-data
pain-relief
intranasal