Patient Experience with 10 mg Intranasally Administered Zavegepant as an Acute Treatment of Migraine Attacks:...

Migraine imposes significant burdens on individuals and healthcare systems. While clinical trials have demonstrated the efficacy and safety of acute treatments, real-world patient experiences offer critical insight into treatment acceptability and impact on quality of life. This study explores patient experience with zavegepant 10 mg intranasal (IN) as an acute treatment for migraine attacks.

Adults with a self-reported migraine diagnosis who had used zavegepant for acute treatment of migraine attacks in the past 3 months participated in semi-structured in-depth interviews. Participants were recruited via a research panel. Interviews explored treatment usage patterns and outcomes. Participants also completed a point allocation exercise, assigning 100 points across seven zavegepant features based on relative importance. Transcripts were analyzed in MAXQDA using content analysis.

Fifteen patients participated (mean age = 42; range 23-63 years). Zavegepant was generally perceived as effective, fast-acting, and convenient, contributing to high overall satisfaction. Patients with multiple migraine medications on hand usually choose zavegepant for severe attacks or when they need to continue performing their planned activities. Many reported receiving insufficient guidance from healthcare providers on correct administration timing and technique. Dysgeusia (a bitter, metallic taste) was commonly reported. Most expressed willingness to continue using zavegepant despite dysgeusia, citing significant physical, emotional, and daily functioning improvements. In the point allocation exercise, "freedom from pain" was rated as the most important attribute, three times more important than "nasal spray as mode of administration" and "taste of the medicine."

Overall, zavegepant 10 mg IN was perceived as an effective and fast-acting acute treatment for migraine attacks. Although side effects such as dysgeusia may delay or reduce use in some patients, most value zavegepant's effectiveness and functional benefits. These findings underscore the need for improved patient education on administration techniques and side effects to optimize real-world outcomes.