Self-Administered Etripamil Cuts ED Visits for PSVT
Self-administered intranasal etripamil was nearly twice as likely as placebo to terminate a paroxysmal supraventricular tachycardia (PSVT) episode within 30 minutes and reduced emergency department (ED) visits by 39%. METHODOLOGY: Researchers conducted two randomized placebo-controlled studies (NODE-301 part 1 and RAPID) that involved 340 patients (mean age, 54.7 years) who experienced PSVT at home.
Participants were randomly assigned to receive 70 mg of intranasal etripamil (n = 206) or placebo (n = 134). In the RAPID study, a second dose of etripamil was permitted 10 minutes after the first if symptoms persisted.
Electrocardiogram recordings were used to confirm the occurrence of PSVT episodes and their termination following study drug administration.
The study outcome was an emergency care visit within 24 hours of treatment. TAKEAWAY: Vagal maneuvers were attempted by 370 patients, but these maneuvers terminated PSVT in only 4.6% of cases without clinician assistance.
PSVT was terminated within 30 minutes in 57.8% of patients who received etripamil vs 32.1% of those who received placebo ( P < .001).
< .001). ED visits occurred in 13.6% of the etripamil group vs 22.4% of the placebo group, reflecting an 8.8% absolute risk reduction and a 39% relative risk reduction (relative risk, 0.61; P = .04).
= .04). Fewer etripamil recipients required additional medical intervention than placebo recipients (14.6% vs 25.4%; P = .01). No serious adverse events were noted with etripamil; the most common events were localized to the nasal administration site. IN PRACTICE:
"Self-administered, outpatient-based treatment for PSVT could contribute to reduced ED visits and cost and complexity of care," the study authors wrote. SOURCE:
The study was led by Sean Pokorney, MD, MBA, Duke University School of Medicine, Durham, North Carolina. It was published online on April 9, 2025, in JAMA Cardiology . LIMITATIONS:
The trials were not individually powered to assess differences in ED visit rates, and data were pooled to achieve statistical power. DISCLOSURES:
This study was funded by Milestone Pharmaceuticals. Several authors reported receiving personal fees from Milestone Pharmaceuticals or having other ties with various sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape Medical News © 2025 WebMD, LLC
Cite this: Edited by Gargi Mukherjee. Self-Administered Etripamil Cuts Emergency Department Visits for Paroxysma Supraventricular Tachycardia - Medscape - May 13, 2025.
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