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Title:
Rapamycin Analogs for Stent-Based Local Drug Delivery | Herz
Description:
The inhibitory action of the sirolimus-like agent everolimus on smooth muscle cell proliferation, evidenced in animal models, has triggered the interest in everolimus as stent coating for local inhibition of in-stent restenosis. For preclinical and clinical evaluation of safety and efficacy of an everolimus-eluting stent design, a new stent has recently been introduced by Biosensors International Inc, covered by a resorbable “composite” coating, that contains the immunosuppressive drug within a polyhydroxyacid biodegradable polymer matrix with roughly equal resorption rates. FUTURE I, the feasibility trial of this new stent concept, revealed a 30-day MACE (major adverse cardiac events) rate of 0% as well as a restenosis rate of 0% at 6-month follow-up in a total of 32 patients included. The more sensitive QCA (quantitative computerized analysis) and IVUS (intravascular ultrasound) parameters showed an 88% reduction of in-stent late loss and an 87% reduction of the neointimal volume. Adding a second feasibility trial including diabetics, the multicenter trial FUTURE II confirmed the initial beneficial findings of FUTURE I in a total of 64 patients in a 1 : 2 randomization to a bare metal control stent. Based on these results, the FUTURE program has now been expanded by Guidant with two large-scale multicenter studies, FUTURE III and IV, which evaluate this stent design in a larger patient population. Furthermore, FUTURE IV is addressed to demonstrate the non-inferiority of this stent concept in a head-to-head comparison to an approved drug-eluting stent (DES) concept. In contrast to everolimus, tacrolimus is a well-known potent antiproliferative agent, already used in various therapeutic areas. Preclinical studies on tacrolimus-eluting stents for treatment of native coronary artery lesions demonstrated safety and efficacy of this stent concept with significant reduction of neointimal proliferation within the implanted study stents. However, the clinical trial program of the first tacrolimus-eluting stent system in the treatment of native coronary lesions (PRESENT I, II) and saphenous vein graft lesions (EVIDENT) failed to prove the clinical benefit of the stent systems tested and demonstrated the impact of specific stent designs, especially the drug carrier characteristics, on the patient outcome. The progressive PRESET study, evaluating a directly coated tacrolimus-eluting stent, will provide important insights, that will clarify the potential of tacrolimus for prevention of neointimal proliferation in clinical practice without being affected by any additional artificial surface compounds.
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Keywords {🔍}
stent, article, everolimus, future, drug, stents, tacrolimus, tacrolimuseluting, privacy, cookies, content, grube, coronary, publish, search, eberhard, restenosis, clinical, efficacy, trial, concept, artery, koronarstents, stentdesigns, access, data, information, log, journal, research, herz, local, buellesfeld, proliferation, coating, instent, evaluation, safety, month, reduction, neointimal, lesions, rahmen, nun, behandlung, discover, author, siegburg, springer, optional,
Topics {✒️}
tacrolimus-eluting stent system approved drug-eluting stent everolimus-eluting stent design eberhard grube md related subjects stent late loss tacrolimus-eluting stents month download article/chapter native coronary lesions future iv tacrolimus-eluting stent everolimus-eluting stent large-scale multicenter studies progressive preset study future iii durch biosensors int resorbable “composite” coating quantitative computerized analysis potent antiproliferative agent der vergangenheit sowie von bypassläsionen article herz aims implanted study stents full article pdf stent coating local inhibition drug carrier characteristics arterial drug retention privacy choices/manage cookies welches potential tacrolimus article grube stent systems tested specific stent designs rapamycin analogs stent restenosis iv future program clinical benefit european economic area initial beneficial findings des provide important insights conditions privacy policy larger patient population heart center siegburg safety evaluation clinical trial program accepting optional cookies agent everolimus guidant
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headline:Rapamycin Analogs for Stent-Based Local Drug Delivery
description:The inhibitory action of the sirolimus-like agent
everolimus on smooth muscle cell proliferation, evidenced in
animal models, has triggered the interest in everolimus as stent
coating for local inhibition of in-stent restenosis. For
preclinical and clinical evaluation of safety and efficacy of an
everolimus-eluting stent design, a new stent has recently been
introduced by Biosensors International Inc, covered by a
resorbable “composite” coating, that contains the
immunosuppressive drug within a polyhydroxyacid biodegradable
polymer matrix with roughly equal resorption rates. FUTURE I,
the feasibility trial of this new stent concept, revealed a
30-day MACE (major adverse cardiac events) rate of 0% as well as
a restenosis rate of 0% at 6-month follow-up in a total of 32
patients included. The more sensitive QCA (quantitative
computerized analysis) and IVUS (intravascular ultrasound)
parameters showed an 88% reduction of in-stent late loss and an
87% reduction of the neointimal volume. Adding a second
feasibility trial including diabetics, the multicenter trial
FUTURE II confirmed the initial beneficial findings of FUTURE I
in a total of 64 patients in a 1 : 2 randomization to a bare
metal control stent. Based on these results, the FUTURE program has now been
expanded by Guidant with two large-scale multicenter studies,
FUTURE III and IV, which evaluate this stent design in a larger
patient population. Furthermore, FUTURE IV is addressed to
demonstrate the non-inferiority of this stent concept in a
head-to-head comparison to an approved drug-eluting stent (DES)
concept. In contrast to everolimus, tacrolimus is a well-known
potent antiproliferative agent, already used in various
therapeutic areas. Preclinical studies on tacrolimus-eluting
stents for treatment of native coronary artery lesions
demonstrated safety and efficacy of this stent concept with
significant reduction of neointimal proliferation within the
implanted study stents. However, the clinical trial program of
the first tacrolimus-eluting stent system in the treatment of
native coronary lesions (PRESENT I, II) and saphenous vein graft
lesions (EVIDENT) failed to prove the clinical benefit of the
stent systems tested and demonstrated the impact of specific
stent designs, especially the drug carrier characteristics, on
the patient outcome. The progressive PRESET study, evaluating a
directly coated tacrolimus-eluting stent, will provide important
insights, that will clarify the potential of tacrolimus for
prevention of neointimal proliferation in clinical practice
without being affected by any additional artificial surface
compounds.
datePublished:
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Coronary artery disease
New device
Everolimus
Tacrolimus
Medikamentenbeschichtete Stents
Koronare Herzkrankheit
Neue Technologie
Everolismus
Cardiology
Internal Medicine
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description:The inhibitory action of the sirolimus-like agent
everolimus on smooth muscle cell proliferation, evidenced in
animal models, has triggered the interest in everolimus as stent
coating for local inhibition of in-stent restenosis. For
preclinical and clinical evaluation of safety and efficacy of an
everolimus-eluting stent design, a new stent has recently been
introduced by Biosensors International Inc, covered by a
resorbable “composite” coating, that contains the
immunosuppressive drug within a polyhydroxyacid biodegradable
polymer matrix with roughly equal resorption rates. FUTURE I,
the feasibility trial of this new stent concept, revealed a
30-day MACE (major adverse cardiac events) rate of 0% as well as
a restenosis rate of 0% at 6-month follow-up in a total of 32
patients included. The more sensitive QCA (quantitative
computerized analysis) and IVUS (intravascular ultrasound)
parameters showed an 88% reduction of in-stent late loss and an
87% reduction of the neointimal volume. Adding a second
feasibility trial including diabetics, the multicenter trial
FUTURE II confirmed the initial beneficial findings of FUTURE I
in a total of 64 patients in a 1 : 2 randomization to a bare
metal control stent. Based on these results, the FUTURE program has now been
expanded by Guidant with two large-scale multicenter studies,
FUTURE III and IV, which evaluate this stent design in a larger
patient population. Furthermore, FUTURE IV is addressed to
demonstrate the non-inferiority of this stent concept in a
head-to-head comparison to an approved drug-eluting stent (DES)
concept. In contrast to everolimus, tacrolimus is a well-known
potent antiproliferative agent, already used in various
therapeutic areas. Preclinical studies on tacrolimus-eluting
stents for treatment of native coronary artery lesions
demonstrated safety and efficacy of this stent concept with
significant reduction of neointimal proliferation within the
implanted study stents. However, the clinical trial program of
the first tacrolimus-eluting stent system in the treatment of
native coronary lesions (PRESENT I, II) and saphenous vein graft
lesions (EVIDENT) failed to prove the clinical benefit of the
stent systems tested and demonstrated the impact of specific
stent designs, especially the drug carrier characteristics, on
the patient outcome. The progressive PRESET study, evaluating a
directly coated tacrolimus-eluting stent, will provide important
insights, that will clarify the potential of tacrolimus for
prevention of neointimal proliferation in clinical practice
without being affected by any additional artificial surface
compounds.
datePublished:
dateModified:
pageStart:162
pageEnd:166
sameAs:https://doi.org/10.1007/s00059-004-2556-6
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Coronary artery disease
New device
Everolimus
Tacrolimus
Medikamentenbeschichtete Stents
Koronare Herzkrankheit
Neue Technologie
Everolismus
Cardiology
Internal Medicine
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