Can DES Survive? The fate of drug-eluting stents
The sales of drug-eluting stents (DES) continue to fall as the controversy of their benefits and safety rages on. DES used to be the rave of in percutaneous coronary intervention (PCI). Since the approval of Cordis CYPHER™ sirolimus-eluting stent in 2003, followed by TAXUS™ paclitaxel-eluting stent a year later, DES have raked in billions of dollars for the pharmaceutical industry in the last 3 years.
Then came the bad news in 2006, when DES came under attack during the World Congress of Cardiology in Barcelona as reports of late stent thrombosis and myocardial infarction trickled in. The COURAGE (NJEM Vol. 356:1503-1516) trial also put doubts on the benefits of DES over mainstream medical therapy.Will DES survive this? Or will it go the way of LYMErex™?* The most recent report on DES from a Danish trial is encouraging. According to Jensen et al. (JACC Vol. 50:463-470), “the minor risk of ST and MI within 15 months after implantation of DES seems unlikely to outweigh the benefit of these stents.”
However, DES sales worldwide continue to decline and doctors are opting back to bare metal stents. Unless the next generation of DES shows better efficacy and safety profiles, the DES era may actually be over.
*Note: LYMErex™ was the vaccine against Lyme borreliosis approved by FDA in 1998. A class action suit due to safety issues was filed in 1999. In the end, Lymerex was cleared but the damage was done. Sales never picked again and the product was withdrawn from the market in 2002 due to lack of demand.
No Comments
Be the first to comment!