Daily Dose: Experimental Nasal Spray Found Effective and Safe for Treating Rapid Heartbeat

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in the Journal of the American Heart Association that examined the safety of etripamil 70 mg nasal spray for the treatment of multiple, spontaneous episodes of paroxysmal supraventricular tachycardia (PSVT) over long-term follow-up.

The study

The NODE-302 open-label extension trial included patients from the phase 3 NODE-301 study. The NODE-301 study assessed etripamil 70 mg in patients with PVST whose symptoms continued despite self-administering a vagal maneuver. Participants applied an electrocardiogram (ECG) patch at the start of symptoms, performed a vagal maneuver, and self-administered etripamil if PSVT continued—keeping the ECG patch on for at least 5 hours. Results showed that etripamil was safe and well tolerated, and the nasal spray was associated with 54% conversion of PSVT to SR within 30 minutes compared with 35% for placebo.

Efficacy outcomes in the NODE-302 study included the probability of conversion of PSVT to SR within 30 minutes of administration of etripamil and the median time to conversion of PSVT episodes over 5 hours of ECG-recorded observation.

Findings

Of the 169 participants (median age, 58 years; 61.9% women; 82.9% White) who transitioned into NODE-302, 105 (62.1%) used etripamil 70 mg for ≥1 perceived episodes of PSVT during the median 232-day follow-up.

The probability of conversion to PSVT within 30 minutes of etripamil administration was 60.2% (median time to conversion, 15.5 minutes) among 188 verified PSVT episodes, and within 60 minutes in 75.1% of the episodes.

When assessing the safety profile, researchers observed 42.9% of the 105 patients who self-administered etripamil at least 1 time for perceived PSVT experienced at least 1 treatment-emergent adverse event.

Authors' comment

"These findings further indicate that self‐administered etripamil has the potential to be safe and effective for treatment of atrioventricular nodal‐dependent supraventricular tachycardia in a medically unsupervised setting over long‐term follow‐up."

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