St. Jude Medical Enrolls First Patient in FAME II Clinical Trial to Study Use of Fractional Flow Reserve Technology in Patients With Stable
Coronary Artery Disease
The Follow-up to the Landmark FAME Trial Will Examine Benefits of
FFR-guided Stenting With Optimal Medical Treatment Compared to Optimal
Medical Treatment Alone
|
|
May 25, 2010 -- St. Paul, Minnesota -- St. Jude Medical, Inc. (NYSE:STJ), a global medical device company,
announced today at EuroPCR that the first patient was enrolled in the
FAME II (Fractional Flow Reserve (FFR)-Guided Percutaneous Coronary
Intervention Plus Optimal Medical Treatment vs. Optimal Medical
Treatment Alone in Patients with Stable Coronary Artery Disease) trial.
The goal of the FAME II trial is to study the role of Fractional Flow
Reserve (FFR) in the treatment of stable coronary artery disease by
comparing the clinical outcomes, safety and cost effectiveness of
percutaneous coronary intervention (PCI) guided by FFR plus optimal
medical treatment (OMT) to OMT alone.
There are many different tools that aid physicians in the treatment of
coronary artery disease. One tool is a coronary angiogram, which is an
X-ray examination of the blood vessels or chambers of the heart. Another
technology that aids physicians in making the best treatment decisions
for their patients is the measurement of FFR, which provides a more
detailed, physiological analysis of blood flow blockages in the heart.
An FFR measurement of above .80 indicates stenting that particular
lesion may not be beneficial, even though the narrowing may look severe
on the X-ray.
Prior to randomization, all patients will have an FFR measurement of
affected arteries using the St. Jude Medical PressureWire(TM) Certus or
PressureWire(TM) Aeris. Patients found to have one or more ischemic lesion
(FFR measurement below .80) will be randomized 1:1 to PCI and OMT or OMT
only. Standard of care for OMT includes the use of aspirin, beta
blockers, anti-anginal medicine, and drugs to reduce cholesterol in the
blood; these treatments help the heart work more efficiently and receive
more oxygen-rich blood. Patients with an FFR measurement indicating
ischemia who are randomized into the PCI and OMT group will receive PCI
with a stent, a small metal mesh tube that is inserted into an artery to
reduce its narrowing and help restore normal blood flow, along with OMT.
The FAME II trial is a follow-up to the landmark FAME (Fractional Flow
Reserve (FFR) vs. Angiography in Multivessel Evaluation) trial, which
compared FFR-guided stenting using the St Jude Medical PressureWire(TM) to
angiographic-guided stenting in patients with 2- or 3-vessel
(multivessel) coronary artery disease. Results demonstrated superior
clinical outcomes in patients whose treatment was guided by FFR prior to
coronary stenting; after two years, the combined risk of death or
myocardial infarction (heart attack) was 34 percent lower for patients
whose treatment was guided by PressureWire technology. In addition to
superior clinical outcomes, the FAME trial also demonstrated that after
one year, the FFR-guided intervention strategy reduced health care costs
per patient by about $2,000, or 14 percent.
The FAME II trial seeks to answer questions as to the
benefits of coronary intervention raised by the recent COURAGE (Clinical
Outcomes Utilizing
Revascularisation and Aggressive
Drug Evaluation) trial, which
demonstrated no difference in the outcomes between PCI and OMT compared
to OMT alone. However, the study did not include use of PressureWire
technology to indicate the presence of ischemia. FAME II will explore
whether FFR-guided interventions provide an added benefit to the
treatment of patients with stable coronary artery disease.
"We expect the FAME II trial to provide further answers and evidence
regarding the optimal way to treat patients with coronary artery
disease," said Bernard De Bruyne, M.D., Ph.D., of the OLV Clinic in
Aalst, Belgium, and coordinating clinical investigator of the FAME II
trial. "I am optimistic that this large-scale, international trial
examining the use of FFR will address the questions raised by the
COURAGE trial about the clinical benefits of PCI by comparing FFR-guided
treatment with optimal medical treatment."
Approximately 1,600 patients at 30 centers in Europe and the United
States who have at least one hemodynamically significant lesion and are
amenable to PCI with drug-eluting stents (unless contraindicated) will
be enrolled in the FAME II trial. The prospective, multicenter,
multinational, randomized trial's primary endpoint will be the 24-month
major adverse cardiac event (MACE) rate, defined as all-cause death,
documented myocardial infarction (heart attack) and unplanned
hospitalization leading to urgent revascularization. Other endpoints
include cost-effectiveness and functional status.
"The FAME trial demonstrated unequivocally that FFR-guided PCI
interventions can improve patient outcomes by reducing the rate of
mortality and heart attack in patients with multivessel coronary artery
disease," said Frank Callaghan, president of the St. Jude Medical
Cardiovascular Division. "St. Jude Medical is pleased to also sponsor
the FAME II trial, which is an important next step to discovering the
benefits of using FFR measurements in a new patient population."
The study's coordinating investigators are Bernard De Bruyne, Professor
Nico Pijls, M.D., Ph.D., of Catharina Hospital in Eindhoven, the
Netherlands and William F. Fearon, M.D., of Stanford University Medical
Center in California.
EuroPCR is the official congress of the European Association of
Percutaneous Cardiovascular Interventions (EAPCI), a leading
international course for interventional cardiovascular specialists.
About Fractional Flow Reserve
Fractional Flow Reserve (FFR) is a physiological index used to determine
the hemodynamic severity of narrowings in the coronary arteries, and can
be measured using the PressureWire Aeris and PressureWire Certus. FFR
specifically identifies which coronary narrowings are responsible for
obstructing the flow of blood to a patient's heart muscle (called
ischemia), and guides the interventional cardiologist in assessing which
lesions warrant coronary interventions, resulting in improved treatment
outcomes.
About the FAME Trial
The FAME study was a randomized, prospective, multi-center trial that
enrolled 1,005 patients with multivessel coronary artery disease. It
compared outcomes for patients whose treatment was guided by FFR to
those whose treatment was guided only by angiography. The 12-month
results, published in the January 15, 2009 issue of the New England
Journal of Medicine, demonstrated that instances of major adverse
cardiovascular events (MACE), including death, myocardial infarction or
repeat revascularization, were reduced by 28 percent for patients whose
treatment was guided by FFR rather than by standard angiography alone.
Two-year results presented as a late-breaking trial during the 2009
Transcatheter Cardiovascular Therapeutics (TCT) Conference demonstrated
that patients who received FFR-guided treatment continued to experience
improved outcomes over time, including a 34 percent risk reduction in
death or myocardial infarction (heart attack).
FFR-guided treatment was also demonstrated to be cost-saving after one
year, with a difference per patient of about $2,000, or 14 percent,
between total health care costs for the FFR-guided group and the group
treated by angiography alone. These lower health care costs were a
result of reduced procedural costs, reduced follow-up costs for MACE and
shorter hospital stays.
About St. Jude Medical
St. Jude Medical develops medical technology and services that focus on
putting more control into the hands of those who treat cardiac,
neurological and chronic pain patients worldwide. The company is
dedicated to advancing the practice of medicine by reducing risk
wherever possible and contributing to successful outcomes for every
patient. St. Jude Medical is headquartered in St. Paul, Minn. and has
four major focus areas that include: cardiac rhythm management, atrial
fibrillation, cardiovascular and neuromodulation. For more information,
please visit sjm.com.
Forward-Looking Statements
This news release contains forward-looking statements within the meaning
of the Private Securities Litigation Reform Act of 1995 that involve
risks and uncertainties. Such forward-looking statements include the
expectations, plans and prospects for the Company, including potential
clinical successes, anticipated regulatory approvals and future product
launches, and projected revenues, margins, earnings and market shares.
The statements made by the Company are based upon management's current
expectations and are subject to certain risks and uncertainties that
could cause actual results to differ materially from those described in
the forward-looking statements. These risks and uncertainties include
market conditions and other factors beyond the Company's control and the
risk factors and other cautionary statements described in the Company's
filings with the SEC, including those described in the Risk Factors and
Cautionary Statements sections of the Company's Quarterly Report on Form
10-Q for the fiscal quarter ended April 3, 2010. The Company does not
intend to update these statements and undertakes no duty to any person
to provide any such update under any circumstance.
Source: St. Jude Medical, Inc.
|