Efficacy and Safety Study of Etripamil Nasal Spray Self-Administration for the Termination of Spontaneous Episodes of Paroxysmal Supraventricular Tachycardia

Sponsor

Ji Xing Pharmaceuticals (Shanghai) Co., Ltd. (Industry)

Overall Status

Recruiting

CT.gov ID

NCT05410860

Collaborator

Milestone Pharmaceuticals Inc. (Other)

500

Enrollment

Locations

Arms

Anticipated Duration (Months)

11.4

Patients Per Site

0.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

To determine whether etripamil nasal spray (NS) self-administered by Chinese patients is superior to placebo at terminating episodes of PSVT in an at-home setting； To evaluate the efficacy of etripamil NS self-administered by Chinese patients compared with placebo on a range of clinical markers.

To evaluate the safety of etripamil NS self-administered by Chinese patients compared with placebo

Condition or Disease	Intervention/Treatment	Phase
Tachycardia, Supraventricular Paroxysmal Supraventricular Tachycardia	Drug: Etripamil NS 70 mg Drug: Placebo	Phase 3

Detailed Description

The study is a multi-center, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of etripamil NS self-administered by patients who experience an episode of PSVT in an at-home setting.

This is an event-driven study. Enrollment into the study will continue until the adjudication of the 180th positively adjudicated PSVT episode in patients treated with double-blind study drug during the Randomized Treatment Period required for the study's pivotal analysis. After the date of the adjudication of the 180th positively adjudicated PSVT episode, all randomized patients will be unblinded at this timepoint and enter into an approximately 6 months open-label period of the study.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

500 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Patients who pass the test dose of the Etripamil NS dosing regimen will be randomized in a 1:1 ratio to Etripamil NS 70mg or placebo using an Interactive Response Technology (IRT) system.Patients who pass the test dose of the Etripamil NS dosing regimen will be randomized in a 1:1 ratio to Etripamil NS 70mg or placebo using an Interactive Response Technology (IRT) system.

Masking:

Triple (Participant, Care Provider, Investigator)

Primary Purpose:

Treatment

Official Title:

Multi-Center, Randomized, Double-Blind, Placebo-Controlled, Efficacy and Safety Study of Etripamil Nasal Spray Self-Administration for the Termination of Spontaneous Episodes of Paroxysmal Supraventricular Tachycardia in Chinese Patients

Actual Study Start Date :

Jun 30, 2022

Anticipated Primary Completion Date :

Dec 1, 2023

Anticipated Study Completion Date :

Jul 1, 2024

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Etripamil NS 70 mg with Optional Second Dose Dosing regimen that permits a second dose of Etripamil NS 70 mg	Drug: Etripamil NS 70 mg Etripamil NS 70 mg will be administered via the Aptar Pharma Nasal Spray Bidose System, supplied as prefilled devices packaged into child-resistant boxes with instructions for use provided in the study drug box.
Experimental: Placebo with Optional Second Dose Dosing regimen that permits a second dose of placebo	Drug: Placebo Placebo will be administered via the Aptar Pharma Nasal Spray Bidose System, supplied as prefilled devices packaged into child-resistant boxes with instructions for use provided in the study drug box.

Arm

Intervention/Treatment

Experimental: Etripamil NS 70 mg with Optional Second Dose

Dosing regimen that permits a second dose of Etripamil NS 70 mg

Drug: Etripamil NS 70 mg

Etripamil NS 70 mg will be administered via the Aptar Pharma Nasal Spray Bidose System, supplied as prefilled devices packaged into child-resistant boxes with instructions for use provided in the study drug box.

Experimental: Placebo with Optional Second Dose

Dosing regimen that permits a second dose of placebo

Drug: Placebo

Placebo will be administered via the Aptar Pharma Nasal Spray Bidose System, supplied as prefilled devices packaged into child-resistant boxes with instructions for use provided in the study drug box.

Outcome Measures

Primary Outcome Measures

Time to an adjudicated termination of a positively adjudicated episode of PSVT and conversion to sinus rhythm (SR) for at least 30 seconds within 30 minutes of start of study drug dosing [Within 30 minutes of start of study drug dosing.]
The primary efficacy endpoint is defined as an adjudicated termination of a positively adjudicated episode of PSVT (AV nodal reentrant tachycardia or AV reentrant tachycardia determination if possible) and conversion to sinus rhythm (SR) for at least 30 seconds within 30 minutes of start of study drug dosing.

Secondary Outcome Measures

Time to conversion at time points of 5, 10, 15, 45, and 60 minutes [1 hour after administration of study drug]
Time to conversion in patients with the option of repeat administration [1 hour after administration of study drug]
The percentage of patients requiring additional medical intervention in emergency department to terminate an episode of PSVT [Up to 2 years]
Number of participants with relief of specific symptoms (i.e., heart palpitations, rapid pulse feeling, chest pain, anxiety, shortness of breath, dizziness, and fainting) [1 hour after administration of study drug]
Rating of Treatment Satisfaction Questionnaire for Medication (TSQM). [1 hour after administration of study drug]
Treatment satisfaction will be analyzed by comparing the Treatment Satisfaction Questionnaire for Medication 9(TSQM-9) score for satisfaction in the 2 treatment groups. The TSQM-9 is composed of 9 questions with responses on a scale of 1 (extremely dissatisfied) to 7 (extremely satisfied). A higher score indicated greater satisfaction with medication.
The percentage of adverse event [Up to 2 years]
Number of participants with arrhythmias and conduction disorders detected on surface electrocardiogram（ECG） or cardiac monitoring system (CMS) recordings. [Up to 2 years]

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Patients who meet all of the following criteria will be eligible to participate in the study:

Male or female patients at least 18 years of age;
Electrographically documented history of PSVT (e.g., diagnosis based on ECG , Holter monitoring, etc.). If patient had a prior ablation for PSVT, patient must have documented ECG evidence of PSVT post-ablation;
History of sustained episodes of PSVT (i.e., typically lasting 20 minutes or longer);
Females of childbearing potential who are sexually active with a male partner who is not surgically sterile (i.e., vasectomy) must agree to use an approved highly effective form of contraception from the time of signed informed consent until 30 days after the last administration of study drug.;

The following categories define females who are NOT considered to be of childbearing potential:

Premenopausal females with 1 of the following:

Documented hysterectomy;
Documented bilateral salpingectomy or tubal ligation; or
Documented bilateral oophorectomy; or

Postmenopausal females, defined as having amenorrhea for at least 12 months without an alternative medical cause; and

Signed written informed consent.

Exclusion Criteria:

Patients who meet any of the following criteria will be excluded from participation in the study:

Systolic blood pressure (SBP) <90 mmHg after a 5-minute rest in sitting position at the Screening Visit or before the test dose. In patients treated with a chronic prophylactic drug for PSVT (e.g., beta blockers, verapamil, and diltiazem), the drug may be stopped for at least the equivalent of 5 half-lives, patients may be rescreened once, and chronic use of the drug cannot be restarted after randomization;
History of severe symptoms of hypotension, especially syncope, during episodes of PSVT;
History of atrial arrhythmia that does not involve the atrioventricular (AV) node as part of the tachycardia circuit (e.g., atrial fibrillation, atrial flutter, intra-atrial tachycardia);
History of allergic reaction to verapamil;
Current therapy with digoxin or any Class I or III antiarrhythmic drug, except if these drugs are stopped at least the equivalent of 5 half-lives before the Test Dose Randomization Visit;
Current chronic therapy with oral amiodarone, or have taken oral amiodarone within 30 days prior to the Test Dose Randomization Visit;
Evidence of ventricular pre-excitation (e.g., delta waves, short PR interval <100 msec, Wolff Parkinson White syndrome) on the ECG performed at the Screening Visit or before the test dose administration;
Evidence of a second- or third-degree AV block on the ECG performed at the Screening Visit or before the test dose administration;
History or evidence of severe ventricular arrhythmia (e.g., torsades de pointes, ventricular fibrillation, or ventricular tachycardia);
Current congestive heart failure defined by the New York Heart Association Class II to IV;
History of Acute Coronary Syndrome or stroke within 6 months of screening;
Evidence of hepatic dysfunction ;
Evidence of End-Stage Renal Disease;
Females who are pregnant or lactating;
Evidence or history of any significant physical or psychiatric condition including drug abuse, which, in the opinion of the Investigator, could jeopardize the safety of patients or affect their participation in the study. Additionally, the Investigator has the ability to exclude a patient if for any reason the Investigator judges the patient is not a good candidate for the study (e.g., illiteracy or poor understanding) or will not be able to follow study procedures;
Participation in any investigational drug or device study or the use of any investigational drug or device within 30 days or five terminal phase half-lives of the drug whichever is longer, prior to the Screening Visit; or
Previously enrolled in a clinical trial for Etripamil and received study drug during a perceived episode of PSVT;
An immediate family member of the participating investigator, sub-investigator, study coordinator, or employee of the participating investigator.

Before randomization in this study, all patients will receive a test dose of an etripamil NS dosing regimen.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Beijing Anzhen Hospital	Beijing	Beijing	China	100032
2	Baotou Central Hospital	Baotou		China
3	The First Affiliated Hospital of Baotou Medical College	Baotou		China
4	Beijing Hospital	Beijing		China
5	Beijing Tongren Hospital, Capital Medical University	Beijing		China
6	Chui Yang Liu Hospital Affiliated to Tsinghua University	Beijing		China
7	Peking Union Medical College Hospital	Beijing		China
8	The Central Hospital of China Aerospace Corporation	Beijing		China
9	The First Hospital of Jilin University	Ch'ang-ch'un		China
10	The Third Xiangya Hospital of Central South University	Changsha		China
11	Xiangya Hospital, Central South University	Changsha		China
12	Changzhou No.2 People's Hospital	Changzhou		China
13	Affiliated Zhongshan Hospital of Dalian University	Dalian		China
14	People's Hospital of Deyang City	Deyang		China
15	The First Affiliated Hospital of Fujian Medical University	Fuzhou		China
16	Nanfang Hospital of Southern Medical University	Guangzhou		China
17	Guizhou Provincial People's Hospital	Guiyang		China
18	Sir Run Run Shaw Hospital, Zhejiang University School of Medicine	Hangzhou		China
19	The First People's Hospital of Hangzhou Linping District	Hangzhou		China
20	Zhejiang Provincial People's Hospital	Hangzhou		China
21	The Affiliated Huainan No.1 People's Hospital of Nanjing Medical University	Huai'an		China
22	Huainan First People's Hospital	Huainan		China
23	Huizhou Municipal Central Hospital	Huizhou		China
24	Jinan Central Hospital	Jinan		China
25	The First Affiliated Hospital of Jinzhou Medical University	Jinzhou		China
26	Lanzhou University Second Hospital	Lanzhou		China
27	The First Affiliated Hospital of Henan Science and Technology University	Luoyang		China
28	Mianyang Central Hospital	Mianyang		China
29	The Nanchang Third Hospital	Nanchang		China
30	The Second Affiliated Hospital of Nanchang University	Nanchang		China
31	Jiangsu Province Hospital	Nanjing		China
32	Nanjing Drum Tower Hospital	Nanjing		China
33	The 2nd affiliated Hospital of Guangxi Medical University	Nanning		China
34	Nanyang Second General Hospital	Nanyang		China
35	Ningbo First Hospital	Ningbo		China
36	Ruijin Hospital of Shanghai Jiaotong University School of Medicine	Shanghai		China
37	Shanghai Pudong New Area People's Hospital	Shanghai		China
38	Shanghai Tongren Hospital	Shanghai		China
39	Shangrao People's Hospital	Shangrao		China
40	Shanxi Cardiovascular Hospital	Taiyuan		China
41	Binhai Hospital (Tianjin Fifth Central Hospital)	Tianjin		China
42	Tianjin Medical University General Hospital	Tianjin		China
43	Union Hospital Tongji Medical College Huazhong University of Science and Technology	Wuhan		China
44	The Fourth Affiliated Hospital Zhejiang University School of Medicine	Yiwu		China