Published: May 19, 2009
NEVO Sirolimus Eluting Coronary Stent incorporating RES Technology (Photo: Business Wire)
BARCELONA, Spain - (BUSINESS WIRE) - At six months, the NEVO Sirolimus-eluting Coronary Stent,
incorporating RES Technology , was superior to the Taxus
Liberte Stent in reducing tissue growth within the stent
that can potentially lead to repeat procedures, in new clinical study
results released today. In addition, no reports of stent thrombosis were
reported in patients treated with NEVO through six months.
The results of the NEVO RES I study comparing these two drug-eluting
stents were presented during Late Breaking Clinical Trials at EuroPCR,
the leading medical conference in Europe for physicians specializing in
interventional cardiovascular medicine.
"We are extremely pleased with the results from this trial and believe
NEVO has the potential to return Cordis to global leadership
in the drug-eluting stent market," said Seth Fischer, Company Group
Chairman and Worldwide Franchise Chairman, Cordis Corporation.
NEVO is the first drug-eluting stent utilizing RES Technology ,
which incorporates hundreds of small reservoirs, each acting as a depot
into which drug-polymer compositions are loaded. This unique design
allows drug delivery from a stent with a surface that is 75 percent bare
metal upon insertion and which becomes purely bare metal following drug
delivery and polymer bioresorption in approximately three months based
on in vivo data. By contrast, currently marketed drug-eluting stents
have 100 percent of their surfaces coated with drug and polymer and the
polymer is never fully bioabsorbed.
The NEVO Sirolimus-eluting Coronary Stent had significantly
lower in-stent late lumen loss, the primary endpoint of this
prospective, randomized clinical trial. Specifically, late lumen loss
was reduced by 64 percent in the NEVO arm as compared to the
Taxus Liberte® arm (0.13 mm compared to 0.36 mm,
p<0.001). In-stent late lumen loss, which is tissue growth within a
stent, reduces the diameter of the lumen thus restricting blood flow
through the stent and can potentially lead to major adverse coronary
events, also known as MACE.
In addition, NEVO also showed superior angiographic results
to the Taxus Liberte® Stent in reducing
restenosis, a reblockage in a stent, at six months. Angiographic
restenosis was reduced 86 percent (1.1 percent in the NEVO
arm compared to 8.0 percent in the Taxus Liberte arm,
p<0.002).
NEVO also reduced the incidence of MACE (major adverse
coronary events) by more than 40 percent compared to the Taxus
Liberte Stent (4.1 percent vs. 7.0 percent respectively;
p=0.226). MACE events occurring between hospital discharge and six
months were reduced 67 percent from 4.8 percent with the Taxus
Liberte Stent to 1.6 percent with NEVO (p=0.08).
NEVO RES I was not designed to show differences in clinical outcomes,
however, patients treated with NEVO had numerically lower
rates of events with respect to target lesion revascularization (1.6
percent for NEVO vs. 3.2 percent for the Taxus
Liberte Stent; p=0.33) and the composite of death or heart
attack (2.6 percent vs. 4. 3 percent respectively; p=0.26) compared to
patients receiving the Taxus Liberte® Stent.
Stent thrombosis can be a significant clinical issue with coronary
stents and frequently results in heart attacks or death. Based on the
ARC (Academic Research Consortium) definitions of stent thrombosis,
which have been adopted by the interventional cardiology community,
there were no reports of stent thrombosis in the 202 patients receiving
NEVO while there were two reports of stent thrombosis in the
192 patients receiving the Taxus Liberte® Stent,
both of whom were on dual anti-platelet therapy at the time.
"In this trial, NEVO was superior to Taxus
Liberte in a number of key safety and efficacy measures,
including the primary end-point of late lumen loss," said Christian
Spaulding, M.D., F.A.C.C., Professor of Cardiology, Assistance
Publique-Paris Decartes University Hospitals, Paris, France and one of
three primary investigators of the NEVO RES I trial. "We also saw an
emerging safety profile with NEVO that adds to our
enthusiasm about the potential of this drug-eluting stent for patients
with coronary artery disease."
Campbell Rogers, M.D., Chief Scientific Officer and Global Head,
Research and Development, Cordis Corporation noted, "Not only did NEVO
significantly outperform Taxus Liberte® in
important measures but these results also indicate that the potential
for a strong safety profile supporting the opportunity for
patient-specific tailoring of the drugs traditionally needed to prevent
thrombosis is quite promising."
Dr. Rogers continued, "Based on these results, the potential for a
strong safety profile with NEVO is quite promising. NEVO
is designed to improve patient outcomes by providing a unique vascular
safety profile, the proven efficacy of Sirolimus and excellent
deliverability."
Results in Diabetic Patients in NEVO RES I
It is widely known that patients with diabetes tend to present with more
complex coronary lesions and are more challenging to treat. In the NEVO
RES 1 study, a similar magnitude of benefit of the NEVO
Sirolimus-eluting Coronary Stent over the Taxus Liberte®
Stent was seen in patients with diabetes as in patients without diabetes.
In a pre-specified subset analysis of the 65 patients with diabetes
completing six-month follow up to date, there was a 60 percent reduction
in in-stent late lumen loss with NEVO versus the Taxus
Liberte Stent (0.17 mm compared to 0.42 mm, p<0.03). The
magnitude of the differences seen in favor of NEVO was
similar to the 65 percent reduction seen in 277 non-diabetic patients
(0.12 mm, compared to 0.34 mm in the Taxus Liberte®
arm, p<0.001).
NEVO RES I Study Overview
The NEVO RES I study is a randomized, multi-center comparison of the NEVO
Sirolimus-eluting Coronary Stent to the Taxus Liberte®
Stent in de novo native coronary artery lesions. Key secondary endpoints
include target lesion failure, target vessel failure, major adverse
cardiac events (MACE), stent thrombosis, target lesion
revascularization, target vessel revascularization, and angiographic
in-stent and in-segment binary restenosis at six months. A subset of
patients in each treatment arm was evaluated via intravascular
ultrasound (IVUS) at six months.
The study involved 394 patients at 40 sites throughout Europe, South
America, Australia and New Zealand. Patients received clinical follow-up
at 30 days and six months and will be followed annually through five
years.
Data from this trial will support a regulatory filing for a CE mark in
countries outside the United States.
The NEVO Sirolimus-eluting Coronary Stent is an
investigational device. It is not yet approved or available for sale in
any market.
About the NEVO Sirolimus-eluting
Coronary Stent
NEVO is made of cobalt chromium, which makes the stent
flexible and conformable with thin struts to maximize vessel coverage.
The biodegradable polymer used to contain and release Sirolimus
facilitates rapid endothelialization and results of pre-clinical studies
indicated no greater inflammation than seen with bare metal stents.
NEVO also contains the same drug, Sirolimus, as the CYPHER
Sirolimus-eluting Coronary Stent, which has now been used in more than
three million people worldwide. Data supporting the safety and efficacy
of Sirolimus in coronary applications is now available out to six years,
and this body of clinical evidence is completely unmatched by any other
anti-restenotic stent.
Upcoming Clinical Trials for NEVO Sirolimus-eluting
Coronary Stent
Cordis Corporation also announced today additional information of the
study designs for upcoming clinical trials for NEVO .
NEVO II will be a global, randomized, non-inferiority trial comparing
NEVO to the Xience V Everolimus-eluting Coronary
Stent. The study plans to enroll several thousand patients with coronary
artery disease and will include expanded enrollment in multiple patient
subgroup. The primary endpoint of the study is target lesion failure at
12-months. The study will be led by Patrick Serruys, M.D., Erasmus
University, Rotterdam, The Netherlands; Stephen Windecker, M.D.,
University of Bern, Switzerland; and Manual Sabate, M.D., Hospital de
Sant Pau, Barcelona, Spain. Results from this trial will provide
long-term data in support of a Pre-market approval (PMA) application
with the U.S. Food and Drug Administration (FDA).
NEVO III will be a non-randomized, single-arm trial evaluating clinical
outcomes in approximately 1,200 patients throughout the U.S. and Canada.
The primary endpoint will be TLF at 12-months. The study will be led by
Dan Simon, M.D., Case Western Reserve University School of Medicine,
Cleveland, OH; and David Kandzari, M.D., Scripps Clinic, San Diego, CA.
NEVO will be compared to the CYPHER Stent
control arm of the CYPHER Stent/DAPT (dual anti-platelet therapy) trial
(described below).
The CYPHER Stent/DAPT trial will enroll approximately 2,000
patients and will compare clinical outcomes in a broad range of patients
receiving DAPT for 12 months versus 30 months after receiving a CYPHER
Stent. This trial will contribute to the company's involvement in a
broader DAPT clinical program, required by the FDA, which involves all
FDA-approved drug eluting stents.
"The NEVO RES I, NEVO II and NEVO III trials will provide us with
comparative data for NEVO against Taxus Liberte®,
Xience and even our own CYPHER Stent," said Dr. Rogers.
"These data will provide physicians and their patients with important
information to assess optimal treatments for coronary artery disease."
About Cordis Corporation
For more than 50 years, Cordis Corporation, a Johnson & Johnson company,
has been a worldwide leader in the development and manufacture of
interventional vascular technology. Through the company's innovation,
research and development, Cordis partners with interventional
cardiologists worldwide to treat millions of patients who suffer from
vascular disease. More information about Cordis Corporation can be found
at www.cordis.com.
*Cordis Corporation has entered into an exclusive worldwide license
with Wyeth for the localized delivery of sirolimus in certain fields of
use, including delivery via vascular stenting. Sirolimus, the active
drug released for the stent, is marketed by Wyeth Pharmaceuticals, a
division of Wyeth, under the name Rapamune. Rapamune is a trademark of
Wyeth Pharmaceuticals.
**The third party trademarks used herein are trademarks of their
respective owners.
(This press release contains "forward-looking statements" as defined in
the Private Securities Litigation Reform Act of 1995. These statements
are based on current expectations of future events. If underlying
assumptions prove inaccurate or unknown risks or uncertainties
materialize, actual results could vary materially from Cordis
Corporation's and/or Johnson & Johnson's expectations and projections.
Risks and uncertainties include general industry conditions and
competition; economic conditions, such as interest rate and currency
exchange rate fluctuations; technological advances and patents attained
by competitors; challenges inherent in new product development,
including obtaining regulatory approvals; domestic and foreign health
care reforms and governmental laws and regulations; and trends toward
health care cost containment. A further list and description of these
risks, uncertainties and other factors can be found in Exhibit 99 of
Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended
December 28, 2008. Copies of this Form 10-K, as well as subsequent
filings, are available online at www.sec.gov,
www.jnj.com
or on request from Johnson & Johnson. Neither Cordis Corporation nor
Johnson & Johnson undertake to update any forward-looking statements as
a result of new information or future events or developments.)
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Cordis Corporation
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