Larik Muhammad Omar, Iftekhar Muhammad Ashhal, Syed Bilal Ulhassan, Ansari Omema, Ansari Mozaena
Dow International Medical College, Dow University of Health Sciences.
Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan.
Ann Med Surg (Lond). 2023 May 15;85(6):2787-2790. doi: 10.1097/MS9.0000000000000843. eCollection 2023 Jun.
Neurological disorders, especially migraines, pose a significant global burden. This has driven the recent innovative research being conducted in the field of anti-migraine therapies, including the discovery of Zavegepant for the treatment of acute migraine attacks. Zavegepant is a novel, first-in-class, intranasally administered calcitonin gene-related peptide (CGRP) receptor antagonist that has recently been approved for use in acute migraine attacks. Recent randomized controlled trials comparing Zavegepant with a placebo have demonstrated favorable results with respect to primary endpoints, as well as a desirable safety profile. The current first-line therapy consists of oral triptans, which are associated with lower efficacy, weaker safety profile, and an unsatisfactory preference rate among patients. Moreover, the intranasal method of administration is a characteristic advantage of Zavegepant, as patients suffering from acute migraine attacks cannot easily ingest oral medication, due to severe nausea and vomiting. In this mini-review, the efficacy and safety of Zavegepant will be compared with those of alternative treatments available for migraines, including oral triptans, intranasal triptans, and other CGRP antagonists currently available in the market. With currently available research, Zavegepant holds superiority over other forms of treatment and can be included in the current treatment guidelines for migraine attacks. However, further research is necessary to effectively assess Zavegepant's long-term efficacy, safety, tolerability, and drug-drug interactions.
神经疾病，尤其是偏头痛，给全球带来了沉重负担。这推动了近期在抗偏头痛治疗领域开展的创新性研究，包括发现了用于治疗急性偏头痛发作的泽韦吉泮。泽韦吉泮是一种新型的、同类首创的经鼻给药的降钙素基因相关肽（CGRP）受体拮抗剂，最近已被批准用于急性偏头痛发作。最近比较泽韦吉泮与安慰剂的随机对照试验在主要终点方面显示出良好结果，且安全性良好。目前的一线治疗包括口服曲坦类药物，其疗效较低、安全性较差，患者的偏好率也不尽人意。此外，经鼻给药方式是泽韦吉泮的一个显著优势，因为患有急性偏头痛发作的患者由于严重恶心和呕吐而难以口服药物。在本综述中，将比较泽韦吉泮与偏头痛其他可用治疗方法（包括口服曲坦类药物、经鼻曲坦类药物以及目前市场上其他CGRP拮抗剂）的疗效和安全性。根据现有研究，泽韦吉泮优于其他治疗形式，可纳入当前偏头痛发作的治疗指南。然而，需要进一步研究以有效评估泽韦吉泮的长期疗效、安全性、耐受性和药物相互作用。
