Bloomberg News

Cook’s Stent Met Efficacy, Safety Goals, FDA Staff Says

October 11, 2011

(Updates with post-approval studies in fifth paragraph.)

Oct. 11 (Bloomberg) -- A drug-coated stent from Cook Medical met safety and effectiveness goals in the treatment of blocked femoral arteries, according to a staff report by U.S. regulators weighing whether to clear the device for sale.

Clinical trials showed closely held Cook’s stent, the Zilver PTX, worked as well as or better than angioplasty and non-medicated stents in unclogging vessels, Food and Drug Administration staff said in a preliminary review released today on the agency’s website. Outside advisers to the FDA will meet Oct. 13 to evaluate the findings.

The device from Bloomington, Indiana-based Cook would be the first drug-coated stent approved in the U.S. to treat peripheral vascular disease in the largest artery of the upper leg. The stent could reduce leg amputations and painful bypass surgeries, the company said after winning approval for the device in Europe two years ago.

In a study of 479 patients, “there were no signals regarding elevated rates of death, stent thrombosis, or stent fracture” in patients treated with Cook’s device,” FDA staff said in the report. “Limited conclusions can be drawn” from that sample size “regarding the detection of rare adverse events.”

Follow-Up Studies

If the device is approved, the company should be required to conduct follow-up studies to further assess the risk of side effects or complications, agency reviewers said in the report.

Abbott Laboratories of Abbott, Illinois, and C.R. Bard Inc. of Murray Hill, New Jersey, are among the manufacturers of devices that treat arterial blockages in the leg.

Peripheral vascular devices, including stents, angioplasty balloons and synthetic grafts, generated $4.3 billion in global revenue last year and may earn $5.6 billion in 2014, according to Technavio, a market research firm in Elmhurst, Illinois.

Peripheral arterial disease affects 8 million to 12 million people in the U.S., according to the Peripheral Arterial Disease Coalition in Lakewood, Colorado. The disease can cause leg pain and raise heart-attack and stroke risks.

Bypass surgery and angioplasty, in which a tiny balloon is inserted into the artery to clear the blockage, are among the standard treatments for the disease, according to the Mayo Clinic in Rochester, Minnesota.

C.R. Bard won FDA approval in 2009 for a non-drug-coated stent to treat femoral artery disease. That device, known as LifeStent, is a flexible mesh tube that expands inside a clogged vessel and holds it open to restore blood flow.

Drug Delivery

The Zilver PTX device from Cook also props open the femoral artery and delivers the drug paclitaxel to reduce the risk that fatty deposits will form new blockages.

Cook’s drug-coated stent, if approved, “can be a serious competitor to other companies in this space,” Bruce Jackson, an analyst with Morgan Joseph TriArtisan Group in New York, said today in an e-mail.

“Restenosis is a problem in peripheral procedures today, just as it was in coronary procedures when drug-eluting stents were first introduced several years ago, and the data show that Zilver can reduce restenosis rates,” Jackson said. “Drug- eluting balloons are another possible approach, since some peripheral vasculature can be difficult to stent.”

Restenosis, or a recurrence of arterial blockages, occurred in 24 percent of patients treated with Cook’s drug-coated stent after 12 months, and 34 percent of patients treated with angioplasty, according to the FDA staff report.

--Editors: Steve Walsh, Bruce Rule

To contact the reporter on this story: Molly Peterson in Washington at mpeterson9@bloomberg.net

To contact the editor responsible for this story: Adriel Bettelheim at abettelheim@bloomberg.net


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