Etripamil Nasal Spray for Recurrent Paroxysmal Supraventricular Tachycardia Conversion: Results From the NODE-303...

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Etripamil is a novel intranasal calcium-channel blocker designed for rapid paroxysmal supraventricular tachycardia (PSVT) termination.
• Previous research established etripamil's safety and efficacy in a medically supervised setting.
• The NODE-303 study assessed etripamil's use for multiple, at-home PSVT episodes without a preceding test dose.

Purpose of the Study:

• To evaluate the safety and efficacy of self-administered etripamil for multiple episodes of paroxysmal supraventricular tachycardia (PSVT) in a real-world, at-home setting.
• To assess the tolerability and effectiveness of etripamil without a prior medically supervised test dose.
• To analyze the safety profile and efficacy of both single and repeat doses of etripamil for PSVT termination.

Main Methods:

• Patients with suspected PSVT initiated ECG monitoring and self-administered etripamil (70 mg) if vagal maneuvers failed.
• A repeat 70 mg dose was permitted for persistent symptoms after 10 minutes.
• Safety was monitored via treatment-emergent adverse events (TEAEs) and ECGs; efficacy was measured by PSVT termination for each episode.

Main Results:

• Over 1000 PSVT episodes were treated with etripamil in 503 patients.
• The most common TEAEs were mild/moderate nasal discomfort (30.2%), congestion (13.9%), rhinorrhea (13.1%), and epistaxis (7.4%), with decreasing frequency across episodes.
• 70.5% of patients converted to sinus rhythm within 60 minutes of the first dose (median 18.3 min), with earlier conversion predicting subsequent success.

Conclusions:

• Self-administered etripamil nasal spray demonstrated good tolerability and effectiveness for PSVT termination in a real-world setting.
• The safety profile was consistent across single and repeat doses for multiple PSVT episodes.
• Etripamil offers a viable option for at-home, self-administered treatment of PSVT.