自己投与された鼻内エトリパミルの症状誘発型,再投与療法による心房内閉節依存性超心房動脈不全 (RAPID):多センター,ランダム化試験
Bruce S Stambler1, A John Camm2, Marco Alings3
1Cardiac Arrhythmia Research and Education, Piedmont Heart Institute, Atlanta, GA, USA.
Lancet (London, England)
|June 18, 2023
まとめ
エトリパミルの鼻スプレーは30分以内で,安全かつ効果的にお陰で, 上心筋高血圧を鼻腔リズムに変換しました. この迅速な治療法により 患者は医療施設の外で 必要な治療を受けることができます
科学分野:
- 心臓病科
- 薬理学について
背景:
- エトリパミルは,パロキシズマ・スプラベントリキュラ・タヒカルディア (PSVT) の試験中の鼻内カルシウムチャネル阻害剤です.
- 現在のPSVTの治療には しばしば医療施設が必要です
研究 の 目的:
- エトリパミル70 mg鼻スプレーの効果と安全性を評価するために,急性PSVTのシヌスリズムへの変換.
- 症状が誘発する,繰り返し投与される治療法を評価するために,医療施設の外で自己投与.
主な方法:
- 記録されたPSVT患者を含む多センターランダム化プラセボ対照試験 (RAPID)
- 患者は症状の発現時にエトリパミルまたはプラセボを自己投与し,再投与の選択肢がありました.
- 主要エンドポイント: 30分以内のシヌスリズムへの変換時間,ECGで確認.
主要な成果:
- エトリパミルは,プラセボ (31%) と比較して,30分以内に著しく高い変換率 (HR2. 62,p< 0. 0001) を示した.
- エトリパミルの治療期間の中央値はプラセボ (53. 5分) よりもかなり短かった.
- ほとんどの治療に起因する有害事象は軽度/ 中等度の鼻部位反応であり,一時的なもので,介入なしに解消した.
結論:
- 症状によって誘発され,自己投与された鼻内エトリパミルは,迅速なPSVT変換において有効で安全であり,プラセボよりも優れている.
- このアプローチは 患者の能力向上と 急性ケアへの介入の必要性を 軽減する可能性を秘めています
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