Acute Treatment of Migraine with Zavegepant Nasal Spray Reduces the Use of Select Analgesics
David Kudrow1, Linda Mosher2, Esther Straghan2, Samantha Sweeney2, Robert Fountaine2
1The Los Angeles Headache Center, 2Pfizer Inc
Objective:
To assess the impact of zavegepant for acute treatment of migraine on the use of select analgesics.
Background:
Zavegepant nasal spray is a calcitonin gene-related peptide receptor antagonist indicated for acute treatment of migraine with or without aura in adults.
Design/Methods:
This was a post-hoc subgroup analysis of an open-label trial in which participants administered zavegepant 10 mg nasal spray for acute treatment of migraine up to 8 times per month for up to 52 weeks (NCT04408794). The use of other gepants, triptans, lasmiditan and ergotamine medications were prohibited throughout the study. The number of days of acute migraine analgesic use per month (henceforth termed “monthly analgesic days” [MADs]) was compared between the overall 52-week long-term treatment (LTT) period and the four-week observation period before LTT (pre-LTT) using paired t-tests for evaluable participants. P-values are nominal.
Results:
Of 603 treated participants, 505 (83.7%) used select analgesics pre-LTT: ibuprofen 44.4%; acetylsalicylic acid/caffeine/paracetamol combination 32.3%; paracetamol 21.6%; and naproxen 12.4%. Among 501 evaluable participants (those using select analgesics pre-LTT with ≥14 days in both pre-LTT and LTT), the mean (SD) MADs pre-LTT was 5.4 (5.79) and mean (SD) change in MADs in the overall LTT was -4.3 (5.07) (P<0.0001). Among 286 evaluable participants with ≥51 weeks in LTT, the mean (SD) MADs pre-LTT was 5.9 (6.13) and mean (SD) change in MADs in the overall LTT was -4.9 (5.48) (P<0.0001). Of these 286 participants, 89.2% had ≥50% MAD reduction, 37.1% had a 100% MAD reduction, and 3.8% had a MAD increase in the overall LTT.
Conclusions:
Acute treatment of migraine with zavegepant nasal spray, up to 8 doses per month for up to 52 weeks, reduced the use of select analgesics in participants taking such medications prior to treatment.