Etripamil nasal spray safe, effective against PSVT

Treatment with self-administered etripamil results in the termination of paroxysmal supraventricular tachycardia (PSVT) episodes among Chinese patients in an at-home setting, according to a study presented at EHRA 2025. 

“Etripamil treatment demonstrated consistent and robust efficacy to rapidly convert PSVT to sinus rhythm (SR) in a medically unsupervised setting in Chinese patients,” said lead author Dr Nan Li from Beijing Anzhen Hospital, Beijing, China. 

“Safety data were favourable, and significantly fewer patients sought emergency department (ED) care in the etripamil group,” she added. 

This study identified patients aged ≥18 years with prior electrocardiographically (ECG) documented PSVT and sustained episodes (ie, ≥20 min). Eligible participants received a test dose of etripamil nasal spray 70 mg, followed by a repeat dose 10 min later after the first. 

Subsequently, Li and her team randomly allocated patients who tolerated the test doses to receive either etripamil or placebo. Patients with PSVT symptoms applied an ECG cardiac monitoring system (CMS) and self-administered intranasal etripamil 70 mg or placebo. If the symptoms persisted beyond 10 min, patients received a repeat dose. 

Finally, an independent adjudication committee reviewed the ECG CMS data to assess the efficacy and safety endpoints of the study. 

“This phase III, multicentre, randomized, double-blind, placebo-controlled study aimed to evaluate the efficacy and safety of etripamil, self-administered by Chinese patients to terminate PSVT in an at-home setting as prompted by their symptoms of PSVT,” Li said. 

A total of 195 medically unsupervised patients took the study drug for a perceived PSVT episode, of whom 168 had a confirmed PSVT: 84 in the etripamil arm and 84 in the placebo arm. 

Li stated that the primary endpoint was met, with etripamil exhibiting its superiority over placebo for the conversion of PSVT to SR for ≥30 s over 30 min following drug administration (hazard ratio, 3.002, 95 percent confidence interval, 1.578–5.711; p=0.0005).  

Kaplan-Meier estimates showed more patients on etripamil vs placebo who achieved conversion by 30 min (40.5 percent vs 15.9 percent). These results persisted for the secondary efficacy endpoint at 10, 15, 45, and 60 min. 

Adverse events 

In addition, fewer patients in the etripamil arm than the placebo arm sought ED care to terminate PSVT (13.1 percent vs 44.0 percent). 

No significant between-group difference was observed in the proportion of patients reporting any treatment-emergent adverse event (TEAE) at 24 h after drug administration (37.4 percent in the placebo arm vs 32.3 percent in the etripamil arm). Most TEAEs occurred at the nasal administration site and were mild in severity. No severe TEAEs occurred. 

“These results are consistent with prior studies and support the potential self-administration of etripamil to treat PSVT in a symptom-prompted, repeat-dose regimen,” Li said.  

“Etripamil nasal spray is a fast-acting, intranasally administered calcium-channel blocker being developed for PSVT,” according to Li.