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.
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.