Biotronik’s Orsiro DES Efficacy Studied in Stent-Level Subanalysis of HOST-IDEA RCT

July 11, 2023—Biotronik announced findings from a post hoc, stent-level analysis of the HOST-IDEA study that compared the efficacy of the company’s Orsiro ultrathin-strut drug-eluting stent (DES) versus the Coroflex Isar ultrathin-strut DES in percutaneous coronary intervention (PCI).

According to the company, the analysis revealed significant differences in efficacy between the two devices. Hyo-Soo Kim, MD, presented the results on behalf of the HOST-IDEA study investigators in a late-breaking trial session at the EuroPCR conference held May 16-19 in Paris, France. Dr. Kim is an interventional cardiologist at Seoul National University Hospital in Seoul, South Korea.

Biotronik noted that HOST-IDEA is a large-scale, multicenter, all-comers randomized controlled trial composed of 2,173 patients who were enrolled at 37 centers in South Korea. Patients were treated with either the Orsiro DES (n = 1,449) or the Coroflex Isar DES (n = 559). The HOST-IDEA trial outcomes, which demonstrated the noninferiority of 3- to 6-month versus 12-month dual antiplatelet therapy (DAPT) after implantation of an ultrathin-strut DES, were first published online in March in Circulation (2023;147:1358-1368).

The company reported that in Dr. Kim’s presentation at EuroPCR, the post hoc analysis of the propensity score–matched population showed that the target lesion failure (TLF) rate was significantly lower for the Orsiro DES (n = 559) compared to the Coroflex Isar DES (n = 559) at 12 months: 1.1% versus 3.4% (hazard ratio, 3.21; 95% CI, 1.28-8.05; P = .01).

The significant difference in TLF was mainly driven by the significant difference in clinically driven target lesion revascularization (CD-TLR) of 0.5% vs 2.6% (P = .01). Additionally, there were significant differences regarding the TLF and net adverse clinical event rates.

Dr. Kim also shared additional findings from the post hoc analysis of the clinical performance of the two devices after either 3-month or 12-month DAPT duration post-PCI. The Orsiro DES performed better for both durations of DAPT, especially at 3 months (TLF, 1.5% vs 3%).

“Our post hoc analysis showed that Orsiro biodegradable polymer sirolimus-eluting stent was associated with significantly better clinical outcomes than the Coroflex Isar polymer-free sirolimus-eluting stent, mainly due to a lower rate of CD-TLR,” concluded Dr. Kim in Biotronik’s press release. “The current results indicate that third-generation DESs with ultrathin struts are not all the same—probably due to the differences in release kinetics and sirolimus dosage. The results are important to guide future directions of the development of DES.”