2) Our expert faculty from here at #ACC24 is Narendra Singh MD @heartdrsingh, #cardiologist & faculty at both @MCG_AUG and College of Health Professions, Mercer University Atlanta. He is Director, Clinical Research at NSC Cardiology, Johns Creek, Georgia. pic.twitter.com/ikrp0qXUll
— cardio-met (@cardiomet_CE) April 8, 2024
4) If you think you remember learning about a novel approach to PSVT here on @cardiomet_ce before, you're right–it may well be that our feed was your introduction to #etripamil–a still-investigational #CCB administered via the 👃. pic.twitter.com/HMbGQh4VCH
— cardio-met (@cardiomet_CE) April 8, 2024
6) Prior #RDBPC trials
— cardio-met (@cardiomet_CE) April 8, 2024
🔓 https://t.co/e6dkHx8qqg
🔓 https://t.co/wzyNGUy0jl
➡️ 70mg #etripamil, or a regimen using a repeat-dose if persistent sx 10 min after the first, self-administered outside the healthcare setting, converted #PSVT to #SR to a significant degree by 30 min.
7b) . . . previous studies required a medically supervised test-dose of #etripamil pre-randomization.
— cardio-met (@cardiomet_CE) April 8, 2024
While >98% of patients passed ✅, we needed assurance that this drug could be dispensed to patients for use on their own. pic.twitter.com/XHVGFXywI9
8b) Here 👇 is the study design: no required test dose, no exclusion of pts w/history of AF/flutter, & up to 4 PSVT episodes could be treated.
— cardio-met (@cardiomet_CE) April 8, 2024
If sx persisted after vagal maneuver, #etripamil 70 mg was self-administered & ECG monitoring data were collected for ≥1hr. pic.twitter.com/mloPrTxDLg
9a) Here's a #CONSORT diagram, baseline characteristics, and info on just what the monitoring system (CMS) told us what was going on when the patient (who of course had had #PSVT before) perceived PSVT. pic.twitter.com/ZQer778dvt
— cardio-met (@cardiomet_CE) April 8, 2024
9c) 🧮20, 118, 62, & 103 pts completed study w/1, 2, 3, & 4 #etripamil-treated perceived #PSVT.
— cardio-met (@cardiomet_CE) April 8, 2024
🛟 In the safety pop, 428 (85.1%) pts took single dose of etripamil; 75 (14.9%) took a repeat dose.
🛟 Study drug d/c in 26 (5.2%); 12 (2.4%) related to tx, 7/12 for 👃discomfort.
10b) For the first, second, third, and fourth #PSVTepisodes, rates of conversion by 60 min ranged from 57.7% to 77.8%. and median times-to-conversion were 14.0-19.1 min. pic.twitter.com/40d85wnVAG
— cardio-met (@cardiomet_CE) April 8, 2024
11a) 1st & foremost, this was a safety study: no test dose, all doses self-admin outside a healthcare setting. So, WAS #etripamil safe?
— cardio-met (@cardiomet_CE) April 8, 2024
🛟 997 #TEAEs in the safety pop
🛟 59.8% of pts had ≥1 TEAE
🛟 43 events in 31 pts judged as severe, occurring in 31/503 patients (6.2%). pic.twitter.com/3oPUjtUTcJ
11c) #AE frequencies were similar after single- and repeat-dosing, but there was a downward trend in the percentage of patients with any #TEAE with successively treated #PSVT episodes. pic.twitter.com/RvBozyS89e
— cardio-met (@cardiomet_CE) April 8, 2024
12) My @heartdrsingh take on the impact of these data: As an investigator it was gratifying to see participating patients delighted to have an option to potentially treat their #PSVT at home promptly and safely.
— cardio-met (@cardiomet_CE) April 8, 2024
14) We all know that symptoms associated with #PSVT, including palpitations, shortness of breath, anxiety, and dizziness, often require medical intervention . . . and patients experience uncertainty between episodes, which is itself also burdensome.
— cardio-met (@cardiomet_CE) April 8, 2024
16) As a reminder, here are "the numbers" from #RAPID 🔓 https://t.co/wzyNGUy0jl: pic.twitter.com/rLybtXtV0O
— cardio-met (@cardiomet_CE) April 8, 2024
17b) The proportion of patients converting to SR by 30 minutes was higher in the #etripamil arm (64.3%) than in the placebo arm (31.2%) & median time to conversion to SR was >3-fold shorter for the etripamil group (17.2 min v 53.5 min). pic.twitter.com/rJi7l0CFW9
— cardio-met (@cardiomet_CE) April 8, 2024
18a) There was greater mean ⬇️ in tachycardic heart rate (THR) from baseline (#etripamil arm, 184 bpm; placebo, 175 bpm) with etripamil administration, pre conversion (–11.0 bpm; P<0.0001); differences were significant 2-60 min after drug, maximal at 17 (–18.1 bpm; P<0.0001). pic.twitter.com/jhDzcehsZG
— cardio-met (@cardiomet_CE) April 8, 2024
18c) While occurrence of #PSVT symptoms was balanced across the treatment arms before study drug administration, a consistently higher proportion of pts reported improvement in symptoms in the #etripamil arm than in the placebo arm.
— cardio-met (@cardiomet_CE) April 8, 2024
19) The authors concluded that in this #RAPID substudy, self-administered👃#etripamil significantly decreased tachycardia & defined #PSVT symptoms versus the placebo arm.
— cardio-met (@cardiomet_CE) April 8, 2024
21a) So if your 🫀 is racing right now, imagine being at #ACC24 and getting these #PSVT management updates LIVE! We tried to make that happen for you. What have you learned?
— cardio-met (@cardiomet_CE) April 8, 2024
21c) It's c. In #RAPID, self-administration of #etripamil was safe in a medically unsupervised setting.
— cardio-met (@cardiomet_CE) April 8, 2024
Now, the most common #AEs reported after administration were:
a. transient chest pain
b. nasal irritation
c. increased anxiety
d. worsening tachycardia
22) And now you're caught up on the latest data for #PSVT mgt from #ACC24. Claim your 🆓 0.5hr CE/#CME certificate now at https://t.co/k3so9dy1Lt. And FOLLOW US for more #MedEd from ACC and afterwards. Thanks to new faculty @heartdrsingh! pic.twitter.com/Acc8M7yLp6
— cardio-met (@cardiomet_CE) April 8, 2024