Drug eluting stents vs. bare metal
This article was originally published in The Gray Sheet
Executive Summary
Enthusiasm for drug-eluting stents "may be exceeding the evidence" supporting their use, leading to placement in patients and lesion types beyond those evaluated in randomized trials, as well as an underestimation of the risk of late stent thrombosis, according to an evidence review by Sanjay Kaul, MD, Cedars-Sinai Medical Center, Los Angeles, et al., published in the June 20 Annals of Internal Medicine. A June 22 Wall Street Journal article citing the review and other data reports that some prominent heart hospitals have cut back on the use of drug-eluting stents, such as Boston Scientific's Taxus paclitaxel-eluting stent and J&J's Cypher sirolimus-eluting stent, in favor of bare metal stents in some cases, citing concerns over late stent thrombosis. Boston Scientific blamed reduced market share and pricing pressures for a 15% year-over-year dip in U.S. Taxus sales in Q1 2006 to $419 mil., but noted a 5% sequential increase in sales compared to the fourth quarter of 2005 due to procedural growth. Despite stabilized market share in recent months, J&J still refers to Cypher as the "primary growth driver" for its Cordis business (1"The Gray Sheet" May 1, 2006, p. 14)...