Evaluation of HealinG of Polymer-Free Biomlimus A9-Coated Stent by Optical Coherence Tomography (EGO-BIOFREEDOM)

• ClinicalTrials.gov Identifier: NCT01760876
• Recruitment Status: Completed
• First Posted: January 4, 2013
• Results First Posted: January 18, 2016
• Last Update Posted: August 14, 2017
• Sponsor: Professor Stephen Lee
• Information provided by (Responsible Party): Professor Stephen Lee, The University of Hong Kong

Study Description

Brief Summary:

Since polymers have been identified as a possible cause of late complications of drug eluting stents, new stents are being designed to improve polymers' biocompatibility or to bond drugs on stents without polymers.

Biolimus A9 is the therapeutic agent used in the BioFreedom drug coated stent. Biolimus A9 is a proprietary semi-synthetic sirolimus derivative. It is highly lipophilic, rapidly absorbed in tissues, and able to reversibly inhibit growth factor-stimulated cell proliferation.

In this study, we use intracoronary optical coherence tomography (OCT) to evaluate the BioFreedom Stents after implantation regarding endovascular healing over time as primary objective; and also to evaluate secondary OCT, angiographic and clinical outcomes at various specific time points.

Condition or disease	Intervention/treatment	Phase
Coronary Disease	Device: coronary intervention	Not Applicable

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Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 106 participants
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Evaluation of Healing the Biofreedom Stent Study
• Study Start Date: December 2012
• Actual Primary Completion Date: August 2015
• Actual Study Completion Date: August 2015

Arms and Interventions

Arm	Intervention/treatment
Experimental: Biofreedom stent; Coronary intervention	Device: coronary intervention; The BioFreedom drug coated stent (DCS) Coronary Stent Delivery System is comprised of three key components

Outcome Measures

Primary Outcome Measures :

1. OCT Findings on Coverage (Degree of Endothelialisation/Coverage) From 1 to 9 Months. [ Time Frame: 1 to 9 months ]

   The percentage of strut coverage and category of coverage (A to F) from 1 month to 9 months by longitudinal sequential OCT assessments.

   A. Definitely uncovered - strut not covered by tissue, and both sides appear square; B. Uncovered with abnormal in-stent tissue - strut covered by irregular tissue or fibrin, and both sides appear square; C. Partially uncovered - strut partially covered by tissue but only one side has a smooth continuous shoulder; D. Covered (protruding) - strut covered by thin continuous tissue on both sides but still extending into the lumen; E. Covered (embedded) - strut covered by continuous tissue or neointima and not interrupting the smooth lumen contour; F. Covered (proliferative) - strut covered with excessive growth of neointima with thickness >0.3 mm.

Secondary Outcome Measures :

1. OCT Endpoints (Neointimal Metrics), QCA Endpoints (Late Lumen Loss at 9 Months), and Clinical Endpoints (MACE at 9 Months and 12 Months). A Subgroup Analysis Would be Performed for Diabetic Patients. [ Time Frame: 9 months and 12 months ]
   Secondary endpoints would consist of OCT endpoints (neointimal area, neointimal thickness, neointimal volume, and percentage neointimal volume ), QCA endpoints (late lumen loss at 9 months), and clinical endpoints (MACE, including stent thrombosis up to 12 months). A subgroup analysis will be performed for DM patients.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 85 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Patient aged 18-85 years old
• Patient indicated for percutaneous coronary intervention with coronary artery disease and without contraindications to implantation of drug eluting stents
• Patient who agrees to have follow-up coronary angiograms

Exclusion Criteria:

• Patient who refuses to consent to multiple coronary angiograms or coronary angioplasty

Contacts and Locations

Locations

Hong Kong

Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hospital Authority

Hong Kong, Hong Kong

Sponsors and Collaborators

Professor Stephen Lee

Investigators

• Principal Investigator: Stephen WL Lee, MD FRCP FACC; Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hospital Authority

More Information

Publications of Results:

Sousa JE, Costa MA, Abizaid AC, Rensing BJ, Abizaid AS, Tanajura LF, Kozuma K, Van Langenhove G, Sousa AG, Falotico R, Jaeger J, Popma JJ, Serruys PW. Sustained suppression of neointimal proliferation by sirolimus-eluting stents: one-year angiographic and intravascular ultrasound follow-up. Circulation. 2001 Oct 23;104(17):2007-11.

Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006 Jul 4;48(1):193-202. Epub 2006 May 5.

Virmani R, Guagliumi G, Farb A, Musumeci G, Grieco N, Motta T, Mihalcsik L, Tespili M, Valsecchi O, Kolodgie FD. Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation. 2004 Feb 17;109(6):701-5. Epub 2004 Jan 26.

Kornowski R, Hong MK, Tio FO, Bramwell O, Wu H, Leon MB. In-stent restenosis: contributions of inflammatory responses and arterial injury to neointimal hyperplasia. J Am Coll Cardiol. 1998 Jan;31(1):224-30.

Ostojic M, Sagic D, Jung R, Zhang YL, Nedeljkovic M, Mangovski L, Stojkovic S, Debeljacki D, Colic M, Beleslin B, Milosavljevic B, Orlic D, Topic D, Karanovic N, Paunovic D, Christians U; NOBORI PK Investigators. The pharmacokinetics of Biolimus A9 after elution from the Nobori stent in patients with coronary artery disease: the NOBORI PK study. Catheter Cardiovasc Interv. 2008 Dec 1;72(7):901-8. doi: 10.1002/ccd.21775.

Tada N, Virmani R, Grant G, Bartlett L, Black A, Clavijo C, Christians U, Betts R, Savage D, Su SH, Shulze J, Kar S. Polymer-free biolimus a9-coated stent demonstrates more sustained intimal inhibition, improved healing, and reduced inflammation compared with a polymer-coated sirolimus-eluting cypher stent in a porcine model. Circ Cardiovasc Interv. 2010 Apr;3(2):174-83. doi: 10.1161/CIRCINTERVENTIONS.109.877522.

Prati F, Cera M, Ramazzotti V, Imola F, Giudice R, Albertucci M. Safety and feasibility of a new non-occlusive technique for facilitated intracoronary optical coherence tomography (OCT) acquisition in various clinical and anatomical scenarios. EuroIntervention. 2007 Nov;3(3):365-70.

• Responsible Party: Professor Stephen Lee, Professor and Chief, The University of Hong Kong
• ClinicalTrials.gov Identifier: NCT01760876 History of Changes
• Other Study ID Numbers: UW 12-454
• First Posted: January 4, 2013
• Results First Posted: January 18, 2016
• Last Update Posted: August 14, 2017
• Last Verified: June 2017

Keywords provided by Professor Stephen Lee, The University of Hong Kong:

Optical Coherence Tomography; Biofreedom Stent

Additional relevant MeSH terms:

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases