Key result
BuMA sirolimus-eluting stent shows no benefit over Excel stent for target lesion failure.
Why the study?
The PANDA III trial aimed to determine whether the effectiveness of the BuMA SES with rapid drug elution and polymer absorption persists at two years compared to the Excel SES.
Does the BuMA sirolimus-eluting stent reduce target lesion failure compared to the Excel sirolimus-eluting stent in an all-comer population undergoing percutaneous coronary intervention?
RCT (n=2,348)
1:1 ratio using a web-based allocation system stratified by centre
Yes
Does the BuMA sirolimus-eluting stent reduce target lesion failure compared to the Excel sirolimus-eluting stent in an all-comer population undergoing percutaneous coronary intervention?
In an all-comer PCI population, two biodegradable polymer-based sirolimus-eluting stents with differing drug elution and polymer absorption kinetics demonstrated similar low rates of target lesion failure at two years.
BuMA and Excel stents yield similar two-year target lesion failure rates; confirms noninferiority and supports either in all-comers.
AIMS: In the PANDA III trial, the novel poly-lactide-co-glycolide polymer-based BuMA sirolimus-eluting stent (SES) was non-inferior to the polylactide polymer-based Excel SES for the primary endpoint of one-year target lesion failure (TLF), with a lower incidence of stent thrombosis. We sought to investigate whether the effectiveness profile of BuMA SES, with more rapid drug elution and polymer absorption kinetics, would persist at two years. METHODS AND RESULTS: A total of 2,348 patients (mean age, 61.2±10.6 years; 24.3% diabetics; 31.2% with acute myocardial infarction within one month) were randomly assigned to receive either BuMA SES (n=1,174) or Excel SES (n=1,174) in the "all-comer" PANDA III trial. Two-year clinical follow-up was available for 2,262 (96.3%) patients. The incidence of TLF and the patient-oriented composite endpoint (PoCE) was low and similar between the BuMA and Excel groups (7.4% vs. 6.9%, p=0.67, and 13.1% vs. 10.9%, p=0.11, respectively). The rate of any revascularisation was significantly higher with the BuMA SES (6.8% vs. 4.6%, p=0.03). Definite and probable thrombosis occurred in 0.7% and 1.4% of patients in the BuMA and Excel groups, respectively (p=0.10). CONCLUSIONS: Two-year rates of TLF and PoCE events were low and similar between the two biodegradable polymer-based SES.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2018) conducted an RCT in Coronary artery disease (n=2,348). BuMA sirolimus-eluting stent vs. Excel sirolimus-eluting stent was evaluated on Target lesion failure (TLF) (RR 1.07, 95% CI 0.79-1.44, p=0.67). At two years, the BuMA sirolimus-eluting stent resulted in a similar rate of target lesion failure compared to the Excel sirolimus-eluting stent (7.4% vs. 6.9%, p=0.67).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: