Fast-acting nasal spray safe for self-treatment of paroxysma
The NODE-301 study demonstrated that a 70-mg dose of etripamil significantly improved PSVT-related symptoms; patient satisfaction and effectiveness of at-home nasal spray therapy for PSVT were higher for etripamil vs. placebo; and etripamil tended to reduce the need for ED medical interventions for PSVT.

After a perceived episode of PSVT, patients were instructed to apply a cardiac monitoring system or an ECG patch. They then performed a trained vagal maneuver. If the episode persisted, the patient administered etripamil 70 mg, one spray in each nostril. An independent adjudicating committee evaluated ECG recordings to determine PSVT episodes and conversion; patients continued in the study for up to 11 treated episodes. Median time in the study was 223 days; mean age was 58 years and 62% of patients were women.

Researchers observed 188 positively adjudicated PVST events in 92 patients. Among those patients, 56.5% used the drug a single time and 43.5% used etripamil for two or more episodes. Kaplan-Meier estimates of time to conversion to sinus rhythm were 60.2% at the end of 30 minutes and 75% at the end of 60 minutes. Median time to conversion was 15.5 minutes. A fast-acting nasal spray was safe and effective for patients self-treating for repeated episodes of paroxysmal supraventricular tachycardia.