Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine
Stewart J Tepper,1 Merrilee R Johnstone2 1Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA, 2Prescott Medical Communications Group, Chicago, IL, USA Abstract: There is a need for fast-acting, non-oral medication options for migraine because some attacks develop rapid...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2018-05-01
|
| Series: | Medical Devices: Evidence and Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/breath-powered-sumatriptan-dry-nasal-powder-an-intranasal-medication-d-peer-reviewed-article-MDER |
| _version_ | 1818997719707942912 |
|---|---|
| author | Tepper SJ Johnstone MR |
| author_facet | Tepper SJ Johnstone MR |
| author_sort | Tepper SJ |
| collection | DOAJ |
| description | Stewart J Tepper,1 Merrilee R Johnstone2 1Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA, 2Prescott Medical Communications Group, Chicago, IL, USA Abstract: There is a need for fast-acting, non-oral medication options for migraine because some attacks develop rapidly and some are accompanied by nausea, vomiting, and gastroparesis, which can hinder oral medication uptake and absorption. The most commonly prescribed migraine medications are oral triptans, with sumatriptan as the most common. However, oral triptans are associated with adverse events (AEs) of atypical sensations that may be problematic for patients. Subcutaneous (SC) injectable sumatriptan and conventional liquid triptan nasal spray formulations are also available, but the frequency of atypical sensations is the highest with SC sumatriptan, and the intense bitter taste of conventional liquid triptan nasal spray discourages use. AVP-825 (ONZETRA® Xsail®) is an intranasal medication delivery system containing 22 mg sumatriptan nasal powder that is now available in the USA for the acute treatment of migraine with or without aura in adults. The objective of this review is to summarize the development of AVP-825, which utilizes unique features of nasal anatomy to achieve efficient absorption and reduced systemic exposure. Literature searches for “sumatriptan nasal powder”, “AVP-825”, and “sumatriptan intranasal” were conducted. Review articles and pharmacokinetic, Phase II and Phase III studies were evaluated. AVP-825 demonstrates an earlier onset of efficacy and lower rate of atypical sensations than the oral standard of care, which can be attributed to its fast absorption and low systemic exposure. AEs of abnormal taste are predominantly mild. These results confirm the initial design concept for AVP-825, which aligned pharmacokinetics, anatomy, and drug presentation in a novel device to achieve optimal outcomes for the acute treatment of migraine. Keywords: migraine, triptan, sumatriptan, AVP-825, intranasal, Onzetra |
| first_indexed | 2024-12-20T21:50:06Z |
| format | Article |
| id | doaj.art-a410bc12c18c4b24b0d02ba73659f58d |
| institution | Directory Open Access Journal |
| issn | 1179-1470 |
| language | English |
| last_indexed | 2024-12-20T21:50:06Z |
| publishDate | 2018-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Medical Devices: Evidence and Research |
| spelling | doaj.art-a410bc12c18c4b24b0d02ba73659f58d2022-12-21T19:25:35ZengDove Medical PressMedical Devices: Evidence and Research1179-14702018-05-01Volume 1114715638111Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraineTepper SJJohnstone MRStewart J Tepper,1 Merrilee R Johnstone2 1Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA, 2Prescott Medical Communications Group, Chicago, IL, USA Abstract: There is a need for fast-acting, non-oral medication options for migraine because some attacks develop rapidly and some are accompanied by nausea, vomiting, and gastroparesis, which can hinder oral medication uptake and absorption. The most commonly prescribed migraine medications are oral triptans, with sumatriptan as the most common. However, oral triptans are associated with adverse events (AEs) of atypical sensations that may be problematic for patients. Subcutaneous (SC) injectable sumatriptan and conventional liquid triptan nasal spray formulations are also available, but the frequency of atypical sensations is the highest with SC sumatriptan, and the intense bitter taste of conventional liquid triptan nasal spray discourages use. AVP-825 (ONZETRA® Xsail®) is an intranasal medication delivery system containing 22 mg sumatriptan nasal powder that is now available in the USA for the acute treatment of migraine with or without aura in adults. The objective of this review is to summarize the development of AVP-825, which utilizes unique features of nasal anatomy to achieve efficient absorption and reduced systemic exposure. Literature searches for “sumatriptan nasal powder”, “AVP-825”, and “sumatriptan intranasal” were conducted. Review articles and pharmacokinetic, Phase II and Phase III studies were evaluated. AVP-825 demonstrates an earlier onset of efficacy and lower rate of atypical sensations than the oral standard of care, which can be attributed to its fast absorption and low systemic exposure. AEs of abnormal taste are predominantly mild. These results confirm the initial design concept for AVP-825, which aligned pharmacokinetics, anatomy, and drug presentation in a novel device to achieve optimal outcomes for the acute treatment of migraine. Keywords: migraine, triptan, sumatriptan, AVP-825, intranasal, Onzetrahttps://www.dovepress.com/breath-powered-sumatriptan-dry-nasal-powder-an-intranasal-medication-d-peer-reviewed-article-MDERmigrainetriptansumatriptanAVP-825intranasalOnzetra |
| spellingShingle | Tepper SJ Johnstone MR Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine Medical Devices: Evidence and Research migraine triptan sumatriptan AVP-825 intranasal Onzetra |
| title | Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine |
| title_full | Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine |
| title_fullStr | Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine |
| title_full_unstemmed | Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine |
| title_short | Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine |
| title_sort | breath powered sumatriptan dry nasal powder an intranasal medication delivery system for acute treatment of migraine |
| topic | migraine triptan sumatriptan AVP-825 intranasal Onzetra |
| url | https://www.dovepress.com/breath-powered-sumatriptan-dry-nasal-powder-an-intranasal-medication-d-peer-reviewed-article-MDER |
| work_keys_str_mv | AT teppersj breathpoweredsumatriptandrynasalpowderanintranasalmedicationdeliverysystemforacutetreatmentofmigraine AT johnstonemr breathpoweredsumatriptandrynasalpowderanintranasalmedicationdeliverysystemforacutetreatmentofmigraine |