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Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine

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,...

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Autores principales: Tepper, Stewart J, Johnstone, Merrilee R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937501/
https://www.ncbi.nlm.nih.gov/pubmed/29760572
http://dx.doi.org/10.2147/MDER.S130900
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author Tepper, Stewart J
Johnstone, Merrilee R
author_facet Tepper, Stewart J
Johnstone, Merrilee R
author_sort Tepper, Stewart J
collection PubMed
description 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.
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spelling pubmed-59375012018-05-14 Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine Tepper, Stewart J Johnstone, Merrilee R Med Devices (Auckl) Review 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. Dove Medical Press 2018-05-03 /pmc/articles/PMC5937501/ /pubmed/29760572 http://dx.doi.org/10.2147/MDER.S130900 Text en © 2018 Tepper and Johnstone. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Tepper, Stewart J
Johnstone, Merrilee R
Breath-powered sumatriptan dry nasal powder: an intranasal medication delivery system for acute treatment of migraine
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 Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937501/
https://www.ncbi.nlm.nih.gov/pubmed/29760572
http://dx.doi.org/10.2147/MDER.S130900
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