Data analysis from the NODE-301 Phase 3 trial suggests that patients self-adminstering Milestone Pharmaceuticals’ etripamil (CARDAMYST) might be able to avoid ER visits for paroxysmal supraventricular tachycardia (PSVT).
- PSVT includes a range of heart-rhythm disorders and occurs in 1 out of 300 patients, leading to unpredictable elevated heart rates that require medical intervention.
- Etripamil is a fast-acting, self-administered, nasal spray calcium channel blocker currently in development for acutely treating atrioventricular-nodal-dependent PSVT.
- Although promising, etripamil recently faced a setback from the FDA due to nitrosamine impurities and questions around its manufacturing process.
Sniffing around for proof of etripamil’s effectiveness, researchers analyzed data from parts 1 and 2 of the NODE-301 trial and found that patients who self-administered the drug were more likely to treat their PSVT episode at home rather than heading to the ER.
- Nasally administering etripamil stopped the PSVT episode within 30 minutes in 57.8% of patients, compared to 32.1% on placebo.
- Part of why so many placebo patients stopped their PSVT episode could be due to the vagal maneuvers (forced gagging, breath holding, etc.) that patients are instructed to perform.
When it came to going to the ER, 13.6% of etripamil recipients required an ER visit for ongoing PSVT versus 22.4% of placebo, leading to a 39% relative risk reduction.
Although PSVT is rare, these results suggest that etripamil could help relieve volume and cost burdens on ERs.
- One NIH study found that mean expenditures per PSVT patient doubled from $11.7k in the year before diagnosis to $24k in the first postdiagnosis year.
The Takeaway
PSVT is unpredictable, so potentially lessening its impact at home could help alleviate burden on patients and providers alike. However, etripamli is still in the works and hasn’t been FDA approved yet for PSVT, so we’ll have to wait and see till then.
