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A new nasal spray treatment, developed by the Pfizer laboratory, seems promising to reduce the pain associated with migraines. The opinion of Dr Dominique Valade, neurologist.
This is good news for all migraine sufferers. According to a study published Thursday, a new nasal spray has shown positive effects against migraine pain. The results of the study are available in the journal Lancet Neurology.
Greater efficiency from 2 hours after treatment
The treatment, which is administered by nasal spray (and not orally), was tested in a double-blind trial between October 27, 2020 and August 20, 2021.
A total of 1,405 people were split into two groups: one receiving a single 10 mg dose of zavegepant and the other a placebo. Participants suffered from two to eight moderate or severe migraine attacks per month, and their untreated attacks lasted an average of more than 30 hours. During the study, participants recorded the intensity of their pain and identified the most bothersome symptom associated with it (phonophobia, photophobia, nausea). They also recorded their level of functional disability during the attack and after treatment.
Result: Zavegepant was effective in the acute treatment of migraine, with freedom from pain (24% versus 15%) and associated symptoms (40% versus 31%) two hours after administration. D
“This molecule has been effective in the acute treatment of migraine, with favorable tolerance and safety profiles. Further testing is needed to establish long-term security and consistency of effects across attacks“, thus noted the researchers.
Clear, “2 hours after the treatment dose, more participants in the Zavegepant group than in the placebo group had no more pain (…) They noticed an absence of their most bothersome symptom“, further specified the study.
Few side effects
Zavegepant is a third-generation, high-affinity, selective, and structurally unique CGRP receptor antagonist, and the only CGRP receptor antagonist in clinical development with both intranasal and oral formulations. Another advantage of the treatment: it has few side effects.
The researchers thus noted dysgeusia (taste alteration), nasal discomfort and nausea as disadvantages, but “hasNo signal of hepatotoxicity due to Zavegepant has been identified“.
For its part, Pfizer said in a statement that this migraine treatment has “demonstrated migraine pain relief within 15 minutes, with relief lasting up to 48 hours for many patients. Zavegepant was well tolerated and no serious adverse events were reported in treated participants“.
A place in care that remains to be clarified
This molecule is well known to the scientific community, according to Dr. Valade, neurologist.
“We’ve been talking about Zavegepant for 10 years. If this molecule has always seemed promising, no drug has ever been released. And yet: this crisis treatment can also be used as a long-term treatment“.
Today, two drugs in the same therapeutic class have been approved in the United States and in Europe (rimegepant in disease-modifying treatment and ubrogepant in crisis treatment). This new dosage form by spray could provide faster relief.
However, to date, no comparative study has been conducted with triptans (main migraine treatments). Similarly, there is little perspective on the effectiveness of these drugs over the long term. So many questions that will have to be answered before migraine patients can have a new therapeutic weapon.