Etripamil nasal spray may help resolve PSVT-related symptoms, says study
USA: Etripamil nasal spray is effective in reducing symptoms related to paroxysmal supraventricular tachycardia (PSVT) and also reduced emergency room visits, according to data from a post-hoc analysis of the NODE-301 trial.
The findings of the study were presented at the American College of Cardiology (ACC) Annual Scientific Session 2021.
Bruce Stambler from Piedmont Heart Institute and colleagues aimed to investigate whether self-administered etripamil was superior to placebo in terminating PSVT events in an outpatient setting.
The study included 156 people who were randomized in the ratio of 2:1 to receive either etripamil (n = 107) or placebo (n = 49) during PSVT. All patients experienced a vagal-maneuver refractory, symptomatic episode of sustained PSVT and were medically unsupervised during self-administration.
Stambler and colleagues evaluated the percentage of patients who required an emergency room intervention or other such intervention to terminate their PSVT at 5 hours post-administration.
Symptom relief and nasal spray satisfaction were evaluated using the Treatment Satisfaction Questionnaire for Medication (TSQM-9), with higher scores indicating higher satisfaction.
Key findings of the study include:
- Etripamil was more effective than placebo at relieving symptoms associated with PSVT including rapid pulse, palpitations, shortness of breath, dizziness and anxiety.
- Etripamil was associated with a 51% reduction in the need for the emergency room compared with placebo.
- There was a 47% prolongation in the time to next emergency room visit following etripamil use versus placebo.
- Of all patients who used etripamil, 12% needed emergency room therapy to terminate PSVT after 116 mins compared with 25% of placebo users after 79 minutes.
- 2 more patients—1 in each treatment arm—required oral rescue medical therapy.
- Patients who used etripamil indicated higher scores of treatment effectiveness (54) than patients who used placebo (35). A similar pattern was noted for global effectiveness—57 versus 43.
- Both treatments were considered highly convenient (etripamil, 74 vs placebo, 76).
Stambler noted etripamil had failed to meet its primary endpoint of time to conversion of PSVT to sinus rhythm compared to placebo over 5 hours—findings which were reported last year. However, a post-hoc analysis showed etripamil was superior to placebo in converting PSVT over the first 45 minutes post-administration.
Stambler emphasized the overall convenience of the medication, noting the importance in such patients.
"The ability to have something on hand to potentially be able to improve symptoms, terminate their arrhythmia puts the control in the patient," he said. "Because [PSVT} is a rhythm disturbance that can create huge anxiety — and importantly, patients don't know when or if this arrhythmia will develop."
Reference:
The study, "Etripamil Nasal Spray Relieves Symptoms and Reduces Emergency Room Interventions In Patients With Paroxysmal Supraventricular Tachycardia (PSVT): Analysis Of Clinical Outcomes In The Node-301 Trial," was presented at ACC 2021.
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