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Etripamil

Phase 3

Atrial Fibrillation | Small molecule | Cardiovascular |Milestone Pharmaceuticals Inc.|Last Updated: Jan 14, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment819
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06716021ReVeRA-301: Etripamil in Atrial Fibrillation Phase 3PHASE3 NOT YET_RECRUITING 750Jan 1, 2027Jan 1, 2030Jan 14, 2026 -
NCT04467905ReVeRA-201: Etripamil in Atrial Fibrillation, Phase 2PHASE2 COMPLETED 69Nov 19, 2020Aug 10, 2023Sep 19, 202418 Canada, Netherlands
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Study Endpoints
Primary Endpoints
Demonstrate the efficacy of etripamil NS over placebo in patients with AF.
30 minutes from first drug administration

The maximum reduction in ventricular rate, measured from ECG CMS recordings, within 30 minutes from first drug administration

The Maximum Reduction in Ventricular Rate, Measured on Holter Monitoring, Within 60 Minutes From Drug Administration.
60 minutes post drug administration

Baseline ventricular rate is defined as the average heart rate over 5 minutes immediately prior to drug administration. Nadir is defined as the lowest moving average heart rate over 5 minutes recorded in the 60 minutes post drug administration.

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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
PlaceboPLACEBO_COMPARATORPatients will self-administer an initial dose of placebo for a perceived episode of AF with RVR, followed by an optional second dose 10 minutes later if symptoms persist.
EtripamilEXPERIMENTALPatients will self-administer an initial dose of etripamil for a perceived episode of AF with RVR, followed by an optional second dose 10 minutes later if symptoms persist.
Interventions
NameTypeDescription
PlaceboDRUGThe formulation of placebo will consist of water, sodium acetate, disodium EDTA, and sulfuric acid to reproduce the same pH as the etripamil formulation.
EtripamilDRUGThe formulation of etripamil is for IN administration and will consist of etripamil, water, acetic acid, disodium ethylene-diamine-tetra-acetic acid (EDTA), and sulfuric acid. The dose of etripamil to be evaluated in this study is 70 mg with an optional second dose of 70 mg 10 minutes after the first dose if symptoms persist.
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo

Inclusion Criteria: 1. Age 18 years and over. 2. Provision of written informed consent. 3. Documented history of symptomatic AF (paroxysmal, persistent, or permanent) with a ventricular rate of ≥110 bpm. * Documentation: electrocardiogram (ECG) tracing (including 12-lead ECG or ECG strip) showi...

Countries:CanadaNetherlands
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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT06716021primaryCompletionDate: changed
LOWMay 24, 2026NCT06716021studyFirstPostDate: changed