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Etripamil NS

Phase 3

Paroxysmal Supraventricular Tachycardia | Small molecule | Cardiovascular |Milestone Pharmaceuticals Inc.|Last Updated: Jul 21, 2026

Success Probability

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Market & Valuation

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Trial Design

NO_TREATMENT_CONTROLLED
Total Trials3
Total Enrollment1,306

FDA Designations

No designations recorded

Clinical trial landscape

Etripamil NS · 4 trials · 2 indications

Phase 3 3Phase 2 1
NCT05410860Efficacy and Safety Study of Etripamil Nasal Spray Self-Administration for the Termination of Spontaneous Episodes of Paroxysmal Supraventricular TachycardiaTachycardia, Supraventricular
COMPLETED500 Analytics
NCT04952610Etripamil Nasal Spray in Patients With Paroxysmal Supraventricular TachycardiaParoxysmal Supraventricular Tachycardia
COMPLETED130 Analytics
NCT04072835Safety Study of Etripamil Nasal Spray for Patients With Paroxysmal Supraventricular Tachycardia. NODE-303Paroxysmal Supraventricular Tachycardia
COMPLETED1,116 Analytics
PHASE3COMPLETED
Efficacy and Safety Study of Etripamil Nasal Spray Self-Administration for the Termination of Spontaneous Episodes of Paroxysmal Supraventricular Tachycardia
Tachycardia, SupraventricularUnlock trial analytics
PHASE3COMPLETED
Etripamil Nasal Spray in Patients With Paroxysmal Supraventricular Tachycardia
Paroxysmal Supraventricular TachycardiaUnlock trial analytics
PHASE3COMPLETED
Safety Study of Etripamil Nasal Spray for Patients With Paroxysmal Supraventricular Tachycardia. NODE-303
Paroxysmal Supraventricular TachycardiaUnlock trial analytics

Study Endpoints

Primary Endpoints

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.

The safety of self-administered etripamil Nasal Spray (NS) for treatment of episodes of PSVT outside of the clinical setting as assessed by patient-reported adverse events.
Up to 3 years
Number of Participants With Adverse Events for Self-administered Etripamil NS Outside of the Clinical Setting.
From Baseline until a maximum of 4 episodes of perceived PSVT are treated with study drug, up to a maximum duration of 40 months.

Number of participants with any adverse events experienced from baseline up to the final study visit including the treatment of up to 4 perceived PSVT episodes.

Efficacy: The percentage of patients converting to sinus rhythm (SR) in the first 15 minutes after administration of etripamil NS.
15 minutes after administration of etripamil NS

A successful conversion is defined as conversion of PSVT to SR that is maintained for at least 30 seconds

Secondary Endpoints

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
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Etripamil NS 70 mg with Optional Second DoseEXPERIMENTALDosing regimen that permits a second dose of Etripamil NS 70 mg
Placebo with Optional Second DoseEXPERIMENTALDosing regimen that permits a second dose of placebo
Etripamil NS 70 mgEXPERIMENTALSelf- administration of a dose of 70 mg of etripamil. Patients will be provided with a maximum of 4 pre-filled devices at a time. If the symptoms of PSVT persist 10 minutes after the first dose of etripamil NS 70 mg, a second dose of etripamil NS 70 mg can be self-administered by the patient. A second dose of etripamil NS 70 mg should be taken not earlier than 10, and not later than 15 minutes after the first dose.
Etripamil NSEXPERIMENTALParticipants self-administered etripamil NS 70 mg. After implementation of protocol amendment 2.1 (16 March 2021), participants had the option to administer a second dose of etripamil 70 mg 10 minutes after the first dose, if PSVT symptoms persisted
Not TreatedNO_INTERVENTIONParticipants not treated with etripamil NS for a PSVT episode.
Etripamil NS 70mgEXPERIMENTALPatients will be administered by study site personnel

Interventions

NameTypeDescription
Etripamil NS 70 mgDRUGEtripamil 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.
PlaceboDRUGPlacebo 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.
Aptar Pharma Nasal Spray Bidose SystemDEVICEAptar Pharma Nasal Spray Bidose System will be supplied as prefilled devices packaged into child-resistant boxes with instructions for use provided in the study drug box.
Etripamil NSDRUGParticipants were provided with an ambulatory Cardiac Monitoring System (CMS) to help document PSVT episodes. The CMS was self-applied by the participant, when PSVT symptoms begin. Participants self-administered etripamil NS if vagal maneuver was ineffective. After implementation of protocol amendment 2.1, participants had the option to administer a second dose of etripamil 70 mg 10 minutes after the first dose, if symptoms persisted. After an episode of PSVT where drug was administered, the participant returned to the investigative site for a study visit and was given the option to continue in NODE-303 and manage up to three subsequent episodes of PSVT with etripamil NS for a maximum of four episodes.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites53

Inclusion Criteria: Patients who meet all of the following criteria will be eligible to participate in the study: 1. Male or female patients at least 18 years of age; 2. Electrographically documented history of PSVT (e.g., diagnosis based on ECG , Holter monitoring, etc.). If patient had a prior a...

Countries:ChinaUnited StatesCanadaArgentinaBrazilColombiaGermanySpain
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Recent Changes (Last 90 Days)

LOWJul 21, 2026NCT05763953lastUpdatePostDate: changed
MEDIUMJun 15, 2026NCT04952610TRIAL_REMOVED: changed

Frequently asked questions about Etripamil NS

What is Etripamil NS used for?

Etripamil NS is an investigational small molecule nasal spray being developed for paroxysmal supraventricular tachycardia (PSVT) and supraventricular tachycardia. It is designed for patients to self-administer during episodes of rapid heart rate to terminate the arrhythmia. The drug is currently in Phase 3 clinical development.

Who makes Etripamil NS?

Etripamil NS is being developed by Milestone Pharmaceuticals Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol MIST. The company is conducting clinical trials to evaluate the safety and efficacy of this nasal spray formulation for the treatment of paroxysmal supraventricular tachycardia.

What phase is Etripamil NS in?

Etripamil NS is in Phase 3 clinical development for paroxysmal supraventricular tachycardia and supraventricular tachycardia. It is an investigational drug, meaning it has not yet been approved by regulatory authorities. Multiple Phase 3 trials have been completed, and a Phase 2 trial in pediatric patients is currently recruiting.

What clinical trials is Etripamil NS in?

Etripamil NS has been studied in several clinical trials. Completed Phase 3 trials include NODE-303 (NCT04072835) with 1,116 patients, NCT04952610 with 130 patients, and NCT05410860 with 500 patients in China. An ongoing Phase 2 trial, NODE-202 (NCT05763953), is recruiting pediatric patients aged 6 years and older.

Is Etripamil NS FDA approved?

Etripamil NS is not FDA approved. It is an investigational drug currently in clinical development for paroxysmal supraventricular tachycardia. The drug has completed Phase 3 trials, but regulatory approval has not been granted. Milestone Pharmaceuticals continues to evaluate its safety and efficacy through ongoing clinical studies.

How does Etripamil NS work?

Etripamil NS is a small molecule nasal spray designed to act on the heart to terminate episodes of paroxysmal supraventricular tachycardia. While the specific molecular target is not disclosed, the drug is formulated for rapid absorption through the nasal mucosa to provide quick relief during arrhythmia episodes. Its exact mechanism of action is under clinical investigation.