Abbott's XIENCE™ V
Everolimus Drug-Eluting Coronary Stent is Approved by FDA
XIENCE V is the Only Drug-Eluting
Stent to Demonstrate Superiority
Over Market-Leading Stent in Clinical
Trials;
Now Available
in United States for Treatment of Coronary Artery Disease
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July 2, 2008 -- Abbott Park, Illinois
-- Surprising analysts on Wall Street, who had recently
written that Abbott's new drug-eluting stent might not be approved
until the fourth quarter, Abbott today announced that the U.S.
Food and Drug Administration (FDA)
has approved
the
XIENCE™ V
Everolimus Eluting Coronary Stent System for the treatment of
coronary artery
disease.
XIENCE V is the only drug eluting stent to have demonstrated
superiority over Boston Scientific's TAXUS® paclitaxel-eluting
coronary stent system in two randomized head-to-head clinical
trials.
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XIENCE V becomes the fourth
drug-eluting stent to become available in the U.S., following
Medtronic's Endeavor, which was approved on February 1. Both
are second generation drug-eluting stents, dubbed "DES 2.0" by
Angioplasty.Org. The XIENCE has the advantage of a rapid exchange
delivery system, allowing a single operator to place the stent.
Because of patient issues, Medtronic's Endeavor is not at this
time available in this configuration.
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XIENCE V will be launched in the United
States immediately. The same stent will also be marketed by Boston
Scientific as the PROMUS™ stent system -- however it is designed
and manufactured by Abbott and
supplied
to Boston
Scientific
as part of a distribution agreement between the two companies.
According to the Wall Street Journal, the agreement states that
40% of the PROMUS revenues will be paid to Abbott but that FDA
approval will trigger an immediate $250 million payment by Abbott
to Boston Scientific.
Follwing is information from Abbott's press release.
"XIENCE V represents an important treatment advance for the estimated 13 million people in the United States suffering from coronary artery disease, and we believe XIENCE V will quickly become the new standard for drug eluting stents given its outstanding clinical results," said John M. Capek, Ph.D., executive vice president, Medical Devices, Abbott. "Physicians
in the United States have been waiting for years to treat their patients
with a technology that delivers on the promise of drug eluting stents
through both ease of use and excellent clinical performance, and
XIENCE V is that technology."
The XIENCE V drug coated stent is used to treat coronary artery disease by propping open a narrowed or blocked artery and releasing the drug, everolimus, in a controlled manner to prevent the artery from becoming blocked again following a stent procedure. Coronary artery disease occurs when plaque build-up narrows the arteries and reduces blood flow to the heart, which can lead to chest pain or a heart attack.
"XIENCE V was designed to improve safety and efficacy compared to earlier generation stents. The long-term clinical data from two studies performed in both the United States and Europe have now confirmed that XIENCE V is a true next-generation drug eluting stent with clinically important benefits for patients," said
Gregg W. Stone, M.D., Columbia University Medical Center; chairman,
Cardiovascular Research Foundation, New York; and principal investigator
of the SPIRIT III U.S. pivotal clinical trial for XIENCE V.
Clinical Data Supporting XIENCE V
The robust clinical program for XIENCE V includes long-term data from a total of 1,362 patients enrolled in the SPIRIT FIRST, SPIRIT II and SPIRIT III trials, as well as continued access and post-approval programs that will enroll more than 14,000 XIENCE V patients.
The FDA approved XIENCE V based, in large part, on superior results from the 1,002 patient SPIRIT III U.S. pivotal clinical trial, in which XIENCE V demonstrated statistical superiority to TAXUS on the study's primary endpoint of in-segment late loss (vessel renarrowing) at eight months, with a statistically significant 50 percent reduction (mean, 0.14 mm for XIENCE V vs. 0.28 mm for TAXUS). XIENCE V also demonstrated statistical non-inferiority to TAXUS in the co-primary endpoint of target vessel failure (TVF, cardiac events related to the stented vessel) at nine months, with an observed 20 percent reduction (7.2 percent for XIENCE V vs. 9.0 percent for TAXUS). TVF is a composite clinical measure of safety and efficacy outcomes defined as cardiac death, heart attack (myocardial infarction or MI) or target vessel revascularization (TVR).
In May 2008, Abbott presented two-year data from the SPIRIT III trial demonstrating that XIENCE V continues to deliver positive clinical benefits for patients. At two years, the XIENCE V demonstrated the following key results:
- A 45 percent reduction in the risk of
major adverse cardiac events (MACE) compared to TAXUS (7.3 percent
for XIENCE V vs. 12.8 percent for TAXUS, p-value=0.004)*. MACE
is an important composite clinical measure of safety and efficacy
outcomes for patients, defined as cardiac death, heart attack
(MI) or ischemia-driven target lesion revascularization (TLR,
repeat procedures driven by lack of blood supply).
- A 32 percent
reduction in the risk of TVF compared to TAXUS (10.7 percent
for XIENCE V vs. 15.4 percent for TAXUS, p-value=0.04)*.
- Low rates of stent thrombosis between
one and two years, defined as very late stent thrombosis, per
Academic Research Consortium
(ARC) definition of definite/probable stent thrombosis (0.3
percent for XIENCE V and 1.0 percent for TAXUS) and per the SPIRIT
III
protocol (0.2 percent for XIENCE V and 1.0 percent for TAXUS).
The ARC definition of late stent thrombosis was developed to
eliminate variability in the definitions across various drug
eluting stent trials.
XIENCE V acts as a scaffolding to prop open clogged arteries and releases the drug everolimus in a controlled fashion to prevent the artery from becoming narrowed again.
* Event rates are based on Kaplan-Meier estimates; p-values are for descriptive purposes only.
"Today's approval of XIENCE V is a reflection of Abbott's ongoing commitment to bring innovation-driven, leading-edge medical technologies to the people who need them," added Capek. "With
one of the largest, most seasoned vascular sales forces in the United
States and with the ability to supply more than half the worldwide
market, we will begin shipping units of XIENCE V immediately to meet
physician demand for this much awaited, next-generation technology."
More About XIENCE V
XIENCE V is built upon Abbott's market-leading bare metal stent,
the MULTI-LINK VISION® Coronary Stent System. The VISION platform
is designed to facilitate ease of delivery, making it easier
for physicians to
maneuver the stent and treat the diseased portion of the artery.
The XIENCE V drug coated stent will be available on both over-the-wire (OTW) and rapid exchange (RX) delivery systems. Rapid exchange is the most widely used type of delivery system because it provides physicians additional flexibility to work as single operators during stent procedures.
XIENCE V was launched in Europe and
other international markets in October 2006. XIENCE V is an investigational
device in Japan and is currently under review for approval by Japan's
Ministry of Health, Labour and Welfare (MHLW) and the Pharmaceuticals
and Medical Devices Agency (PMDA).
Everolimus, developed by Novartis Pharma
AG, is a proliferation signal inhibitor, or mTOR inhibitor, licensed
to Abbott by Novartis for use on its drug eluting stents. Everolimus
has been shown to inhibit in-stent neointimal growth in the coronary
vessels following stent implantation, due to its antiproliferative
properties.
Additional information about XIENCE V, including important safety and effectiveness information, is available online at www.xiencev.com.
About Abbott Vascular
Abbott Vascular, a division of Abbott, is
one of the world's leading vascular care businesses. Abbott Vascular
is uniquely focused on advancing the treatment of vascular disease
and improving patient care by combining the latest medical device
innovations with world-class pharmaceuticals, investing in research
and development and advancing medicine through training and education.
Headquartered in Northern California, Abbott Vascular offers a comprehensive
portfolio of vessel closure, endovascular and coronary products.
About
Abbott
Abbott (NYSE: ABT) is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs more than 68,000 people and markets its products in more than 130 countries.
Source: Abbott Vascular with additional reporting
by Burt Cohen of Angioplasty.Org
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