Khan Zainab Z, Ahmed Usman, Shahzad Faizan, Ali Muaz, Tousif Kashif, Ahmed Usman, Muhammad Safwan Qazi, Naufil Syed Imam, Murtaza Sara, Saeed Sajeel, Basit Jawad, Haider Tehseen, Shabbir Haroon
Neurology, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK.
Pediatric Surgery, Rawalpindi Medical University, Rawalpindi, PAK.
Cureus. 2023 Jul 17;15(7):e41991. doi: 10.7759/cureus.41991. eCollection 2023 Jul.
Drugs that act on the calcitonin gene-related peptide (CGRP) pathway herald the dawn of a new era in the management of migraine headaches. The blockade of CGRP alleviates neural inflammation and has been associated with reduced pain sensitization. Zavegepant is a third-generation drug and is the first intranasal CGRP antagonist to be developed. This systematic review aims to assess the safety, efficacy, pharmacokinetics, and tolerability of Zavegepant as an abortive treatment for migraine. Studies that assessed the safety, tolerability, and efficacy of Zavegepant for migraine were identified through a systematic literature review of PubMed, Clinicaltrials.gov, and Cochrane databases in April 2023. Our systematic review yielded a total of six studies that fit our inclusion criteria. Of these, data from only two randomized control trials (RCTs) was homogenous; hence, forest plots of results pooled from the included studies were not reported. The included studies showed that Zavegepant is an efficacious and well-tolerated abortive treatment modality for episodic migraine in adult patients. Zavegepant showed safety and efficacy in migraine treatment according to various parameters throughout the six included studies. These parameters include adverse events, pharmacokinetic properties, CGRP inhibition, effect on blood pressure/electrocardiogram, pain freedom, and freedom from most bothersome symptoms.
作用于降钙素基因相关肽（CGRP）通路的药物预示着偏头痛治疗新时代的到来。CGRP的阻断可减轻神经炎症，并与疼痛敏感性降低有关。扎韦普坦是一种第三代药物，是首个研发的鼻内CGRP拮抗剂。本系统评价旨在评估扎韦普坦作为偏头痛 abortive 治疗的安全性、有效性、药代动力学和耐受性。通过对PubMed、Clinicaltrials.gov和Cochrane数据库在2023年4月进行系统文献回顾，确定了评估扎韦普坦治疗偏头痛的安全性、耐受性和有效性的研究。我们的系统评价共产生了六项符合纳入标准的研究。其中，只有两项随机对照试验（RCT）的数据是同质的；因此，未报告纳入研究汇总结果的森林图。纳入研究表明，扎韦普坦是成人发作性偏头痛一种有效且耐受性良好的 abortive 治疗方式。在六项纳入研究中，根据各种参数，扎韦普坦在偏头痛治疗中显示出安全性和有效性。这些参数包括不良事件、药代动力学特性、CGRP抑制、对血压/心电图的影响、疼痛缓解以及摆脱最困扰症状。
