Abbott Stent Tops Older Boston Scientific Device In Big Study
September 23 2009 - 2:40PM
Dow Jones News
One-year data from a large study showed an Abbott Laboratories
(ABT) heart stent again outperformed an older device from Boston
Scientific Corp. (BSX) by leading to lower rates of serious events,
adding to evidence that has helped make Abbott's device a market
leader.
The 3,690-patient, Abbott-sponsored "Spirit IV" trial showed
similar performance between the Abbott and Boston Scientific stents
among a subgroup of diabetic patients. However, the study has set
the table for Boston Scientific to defend its turf among a patient
group it has targeted. Data from the study were released Wednesday
at the Transcatheter Cardiovascular Therapeutics conference in San
Francisco.
The devices at issue are drug-coated stents, which prop open
clogged heart arteries and use medication to combat renarrowing.
They make up a roughly $4 billion global market. Abbott and Boston
Scientific are big competitors, although they also share some
business because Boston Scientific sells the Abbott-made Xience
device under a different name and a profit-sharing deal.
Because of that deal, good data for Xience can help or hurt
Boston Scientific depending on how it affects sales of its
different stents. The company's home-grown Taxus-brand stents,
which were matched up against Xience in the Spirit IV trial, are
more profitable for the company.
Specifically, Spirit IV showed Xience topping Taxus Express, an
older device Boston Scientific has essentially replaced with a new
version called Taxus Liberte. Abbott believes the study results
remain relevant because the Boston Scientific stents are similar.
Boston Scientific, however, argued that Liberte is better than the
older version on certain fronts - data released on Tuesday showed
benefits for the newer version in small arteries and long areas
needing treatment, for example.
Whether stent-implanting doctors will shift business due to the
Spirit IV study, which Abbott believes is possible, remains to be
seen.
The study included twice as many patients with Xience devices as
Taxus Express stents. The main measurement was a combination of
death from heart events, heart attacks linked to the problem
artery, and retreatment of the problem area due to restricted blood
flow. On this composite measurement, known as target lesion
failure, the rate at one year for patients treated with Xience was
4.2%, while it was 6.8% with Taxus Express.
On the specific measure of retreatment in the problem area, the
rate was 2.5% with Xience and 4.6% with Taxus Express. Notably,
this study did not include routine patient follow-up with angiogram
imaging tests - doctors believe this can fuel repeat procedures due
to narrowing they see, but isn't causing discomfort.
The study also showed a lower rate of rare but dangerous
stent-related clots, which are a closely watched complication, with
the Xience device at one year.
The results come two days after Abbott released a three-year
update from its Spirit III study measuring Xience against Taxus
Express. That study, which helped Abbott gain access to the U.S.
market where Xience supplanted Taxus as the top-selling stent, also
showed superior Xience performance.
Because nearly a third of patients in the bigger Spirit IV study
are diabetics - a group that Boston Scientific in particular has
targeted - results for this group were highly anticipated.
On the diabetes front, the rates of events were similar between
the two stents despite the Xience advantages among non-diabetics.
The study "actually supports Boston Scientific in relation to the
diabetic outcome, even though we're using our last generation
stent," said Keith Dawkins, the associate chief medical officer at
Boston Scientific, in an interview.
Cardiologist Gregg Stone, the study's main investigator, noted
that diabetics tend to have smaller vessels that are prone to
re-clogging. Stone, who serves on both the Abbott and Boston
Scientific advisory boards, is a professor of medicine at Columbia
University Medical Center.
He said outcomes for diabetics can still be improved and should
be an area of focus for future drugs and stents.
-By Jon Kamp, Dow Jones Newswires; 617-654-6728;
jon.kamp@dowjones.com