{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:22:12Z","timestamp":1783689732011,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"abstract":"Abstract<\/jats:title>\n \n Objectives\/Background<\/jats:title>\n The introduction of calcitonin gene\u2010related peptide antagonists has transformed migraine care. Zavegepant, a third\u2010generation intranasal gepant, offers a nonoral treatment option for acute migraine. Although clinical trials support its efficacy and safety, real\u2010world data are limited. This study reports patient\u2010reported outcomes of zavegepant at a tertiary care center using the Migraine Treatment Optimization Questionnaire\u20105 (MTOQ\u20105) and additional survey questions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this single\u2010center, descriptive, cross\u2010sectional survey study of a retrospectively identified real\u2010world cohort, data were collected from patients prescribed 10\u2009mg intranasal zavegepant at the Cleveland Clinic between July 1, 2023, and December 31, 2024. Surveys were administered from January 2025 to March 2025. Eligible patients completed the MTOQ\u20105 and additional questions assessing dosage frequency, pain freedom, freedom from the most bothersome symptom, adverse events, and willingness to reuse zavegepant. Demographics including race, ethnicity, sex, age, body mass index, monthly migraine days, headache\u2010free days, and number of preventive and rescue therapies prescribed prior to zavegepant use were also recorded. Of 99 patients surveyed, 60 responded and met inclusion criteria and were included in the analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 60 included patients who used at least two doses, 27 of 60 (45%) patients reported pain freedom within 2\u2009h of most attacks half the time or more, 17 of 60 (28%) reported less than half the time, and 16 of 60 (27%) reported never achieving pain freedom within 2\u2009h. After zavegepant administration, 38 of 60 (63%) patients reported pain freedom within 2\u2009h, and 10 of 60 (17%) patients reported pain freedom within 30\u2009min of use. One dose of zavegepant relieving headache for at least 24\u2009h was reported half the time or more in 26 of 60 (43%) patients. Following zavegepant use, 36 of 60 patients (60%) reported being able to return to normal activities half the time or more, and 43 of 60 (72%) felt comfortable planning daily activities half the time or more with zavegepant. Zavegepant was well\u2010tolerated half the time or more in 41 of 60 (68%) patients. Dysgeusia was the most common adverse event reported. Overall, 43 of 60 (72%) patients would use zavegepant again.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study represents the first retrospective, real\u2010world, patient\u2010reported outcome study on the use of zavegepant using the validated MTOQ\u20105. These findings suggest that intranasal zavegepant may be a useful acute migraine treatment option in clinical practice, with patient\u2010reported improvement in pain, most bothersome symptom, function, tolerability, and willingness to reuse. However, the descriptive single\u2010arm design and exclusion of single dose or nonusers limit interpretation and preclude comparative conclusions. Further real\u2010world follow up with larger sample sizes is warranted to validate these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.70163","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:44:47Z","timestamp":1783687487000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010world outcomes of zavegepant use in a tertiary care setting using the Migraine Treatment Optimization Questionnaire\u20105"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5354-7195","authenticated-orcid":false,"given":"Eric","family":"Dunn","sequence":"first","affiliation":[{"name":"Center for Neurological Restoration Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-1967","authenticated-orcid":false,"given":"Bradley","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Neurology Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Center for Neurological Restoration Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Popov","sequence":"additional","affiliation":[{"name":"Center for Neurological Restoration Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Sonneborn","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Learner Research Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarushi","family":"Suneja","sequence":"additional","affiliation":[{"name":"Center for Neurological Restoration Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"12","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S1474-4422(25)00402-8","article-title":"Global, regional, and national burden of headache disorders, 1990\u20132023: a systematic analysis for the global burden of disease study 2023","volume":"24","author":"GBD 2023 Headache Collaborators","year":"2025","journal-title":"Lancet Neurol"},{"issue":"5","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/j.1526-4610.2004.04078.x","article-title":"Triptan cardiovascular safety expert panel. 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statement","volume":"12","author":"Benchimol E","year":"2015","journal-title":"PLoS Med"},{"issue":"10","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1007\/s11606-021-06737-1","article-title":"A consensus\u2010based checklist for reporting of survey studies (CROSS)","volume":"36","author":"Sharma A","year":"2021","journal-title":"J Gen Intern Med"},{"key":"e_1_2_9_14_1","first-page":"1","article-title":"The international classification of headache disorders, 3rd edition","volume":"38","author":"Headache Classification Committee of the International Headache Society (IHS)","year":"2018","journal-title":"Cephalalgia"},{"issue":"4","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/head.14692","article-title":"Calcitonin gene\u2010related peptide\u2010targeting therapies are a first\u2010line option for the prevention of migraine: an American Headache Society position statement update","volume":"64","author":"Charles AC","year":"2024","journal-title":"Headache"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1111\/head.14153","article-title":"The American Headache Society consensus statement: update on integrating new migraine treatments into clinical practice","volume":"61","author":"Ailani J","year":"2021","journal-title":"Headache"},{"issue":"3","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/WNF.0000000000000588","article-title":"Zavegepant for acute treatment of migraine: a systematic review and meta\u2010analysis of randomized controlled trials","volume":"47","author":"Suresh V","year":"2024","journal-title":"Clin Neuropharmacol"},{"issue":"1","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s10194-025-01984-7","article-title":"The efficacy and safety of zavegepant nasal inhalation versus oral calcitonin\u2010gene related peptide receptor antagonists in the acute treatment of migraine: a systematic review and network meta\u2010analysis of the literature","volume":"26","author":"Zhu Z","year":"2025","journal-title":"J Headache Pain"},{"issue":"9","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1111\/head.14389","article-title":"Zavegepant nasal spray for the acute treatment of migraine: a phase 2\/3 double\u2010blind, randomized, placebo\u2010controlled, dose\u2010ranging trial","volume":"62","author":"Croop R","year":"2022","journal-title":"Headache"},{"issue":"1","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s40122-025-00800-z","article-title":"Patient\u2010reported outcomes during the acute treatment of migraine with Zavegepant nasal spray: results from 52\u2010week, open\u2010label study","volume":"15","author":"Lipton RB","year":"2026","journal-title":"Pain 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