Milestone Pharmaceuticals (MIST) Study update summary

Overview of study and clinical context

• Etripamil is an investigational nasal calcium channel blocker for acute self-treatment of paroxysmal supraventricular tachycardia (PSVT), currently under FDA review.

• The study update featured a fireside chat with two key opinion leaders, a cardiac electrophysiologist and a clinical cardiologist, discussing real-world management of PSVT.

• Community-based providers manage the majority of PSVT patients and are key to evaluating new interventions.

• Wearable technologies are increasing early identification and diagnosis of PSVT.

• The event included Q&A with analysts, focusing on patient eligibility, treatment patterns, and adoption of new therapies.

Burden of PSVT and patient experience

• PSVT affects a diverse patient population, from teenagers to the elderly, often undiagnosed for years.

• Patients experience significant anxiety and loss of control due to unpredictable episodes, impacting quality of life.

• Beta blockers and other chronic medications are commonly used but have limited efficacy and undesirable side effects.

• Ablation is effective but often reserved for patients with frequent or intolerable episodes due to procedural risks.

• Case studies highlighted the need for non-invasive, rapid-acting, as-needed therapies, especially for women of childbearing age and those with infrequent episodes.

Current treatment landscape and unmet needs

• Most PSVT patients are initially managed by general cardiologists with lifestyle modifications and oral medications.

• Oral medications have delayed onset and are not ideal for acute episode management; pill-in-the-pocket strategies are limited by slow absorption.

• Ablation is curative but not preferred by many patients due to procedural risks and wait times for scheduling.

• There is dissatisfaction with current options, and a significant unmet need exists for a rapid, self-administered, non-invasive treatment.