PDF(Pubmed)
Abstract：
BACKGROUND: Paroxysmal supraventricular tachycardia (PSVT) treatment requires medically supervised intervention. Etripamil is a novel short-acting calcium channel blocker. Its intranasal spray formulation has a rapid onset of action and shows promise for the unsupervised treatment of PSVT.
OBJECTIVE: We aimed to evaluate the efficacy and safety of etripamil nasal spray for the acute conversion of PSVT.
METHODS: A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching the PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane databases through to 1 December 2022. RevMan version 5.4 software was used to pool dichotomous outcomes using risk ratio (RR) presented with the corresponding confidence interval (CI).
RESULTS: Three RCTs with a total of 496 participants were included in our analysis. Etripamil was effective for PSVT conversion at 15 min (RR 1.84, 95% CI 1.37-2.48), 30 min (RR 1.86, 95% CI 1.42-2.44), and 60 min (RR 1.25, 95% CI 1.05-1.50) after drug administration; decreasing medical intervention-seeking (RR 0.58, 95% CI 0.37-0.90); and decreasing emergency room (ER) visits (RR 0.61, 95% CI 0.38-0.97). However, there was no difference at 300 min (RR 1.10, 95% CI 0.97-1.25) and it was associated with higher rates of adverse events (RR 3.17, 95% CI 2.15-4.69).
CONCLUSIONS: Etripamil nasal spray was effective and well tolerated to induce PSVT termination for up to 60 min. Therefore, etripamil nasal spray constitutes a promising strategy for PSVT self-termination without medical supervision; however, further RCTs are required before endorsement in clinical practice.
OBJECTIVE: We aimed to evaluate the efficacy and safety of etripamil nasal spray for the acute conversion of PSVT.
METHODS: A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching the PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane databases through to 1 December 2022. RevMan version 5.4 software was used to pool dichotomous outcomes using risk ratio (RR) presented with the corresponding confidence interval (CI).
RESULTS: Three RCTs with a total of 496 participants were included in our analysis. Etripamil was effective for PSVT conversion at 15 min (RR 1.84, 95% CI 1.37-2.48), 30 min (RR 1.86, 95% CI 1.42-2.44), and 60 min (RR 1.25, 95% CI 1.05-1.50) after drug administration; decreasing medical intervention-seeking (RR 0.58, 95% CI 0.37-0.90); and decreasing emergency room (ER) visits (RR 0.61, 95% CI 0.38-0.97). However, there was no difference at 300 min (RR 1.10, 95% CI 0.97-1.25) and it was associated with higher rates of adverse events (RR 3.17, 95% CI 2.15-4.69).
CONCLUSIONS: Etripamil nasal spray was effective and well tolerated to induce PSVT termination for up to 60 min. Therefore, etripamil nasal spray constitutes a promising strategy for PSVT self-termination without medical supervision; however, further RCTs are required before endorsement in clinical practice.
摘要：
背景：阵发性室上性心动过速（PSVT）治疗需要医学监督干预。Etripamil是一种新型的短效钙通道阻滞剂。其鼻内喷雾制剂具有快速起效的作用,并且显示出对于PSVT的无监督治疗的希望。
目的：我们旨在评估依替帕米鼻喷雾剂治疗PSVT急性转换的有效性和安全性。
方法：综合随机对照试验（RCT）的系统评价和荟萃分析，通过系统地搜索PubMed来检索，EMBASE,WebofScience,Scopus,和Cochrane数据库至2022年12月1日。RevMan5.4版软件用于使用风险比（RR）和相应的置信区间（CI）汇集二分结果。
结果：我们的分析中包括了三个RCT，共有496名参与者。在15分钟时，依曲帕米对PSVT转换有效（RR1.84，95%CI1.37-2.48），30分钟（RR1.86，95%CI1.42-2.44），给药后60分钟（RR1.25，95％CI1.05-1.50）；减少医疗干预寻求（RR0.58，95％CI0.37-0.90）；减少急诊室（ER）就诊（RR0.61，95％CI0.38-0.97）。然而,300min时无差异(RR1.10,95%CI0.97-1.25),且与较高的不良事件发生率相关(RR3.17,95%CI2.15-4.69).
结论：依曲帕米鼻喷雾剂可有效诱导PSVT终止60分钟，且耐受性良好。因此,在没有医疗监督的情况下，etripamil鼻喷雾剂构成了PSVT自我终止的有希望的策略;然而，在临床实践中认可之前,需要进一步的随机对照试验.
目的：我们旨在评估依替帕米鼻喷雾剂治疗PSVT急性转换的有效性和安全性。
方法：综合随机对照试验（RCT）的系统评价和荟萃分析，通过系统地搜索PubMed来检索，EMBASE,WebofScience,Scopus,和Cochrane数据库至2022年12月1日。RevMan5.4版软件用于使用风险比（RR）和相应的置信区间（CI）汇集二分结果。
结果：我们的分析中包括了三个RCT，共有496名参与者。在15分钟时，依曲帕米对PSVT转换有效（RR1.84，95%CI1.37-2.48），30分钟（RR1.86，95%CI1.42-2.44），给药后60分钟（RR1.25，95％CI1.05-1.50）；减少医疗干预寻求（RR0.58，95％CI0.37-0.90）；减少急诊室（ER）就诊（RR0.61，95％CI0.38-0.97）。然而,300min时无差异(RR1.10,95%CI0.97-1.25),且与较高的不良事件发生率相关(RR3.17,95%CI2.15-4.69).
结论：依曲帕米鼻喷雾剂可有效诱导PSVT终止60分钟，且耐受性良好。因此,在没有医疗监督的情况下，etripamil鼻喷雾剂构成了PSVT自我终止的有希望的策略;然而，在临床实践中认可之前,需要进一步的随机对照试验.
