Boston Scientific has announced positive results from the REPRISE III clinical trial, presented at the annual EuroPCR Scientific Program, in Paris. Data from the study demonstrated that the LOTUS Valve System, a transcatheter aortic valve implantation (TAVI) system, showed superiority over the CoreValve TAVI System platform for the primary effectiveness endpoint and non-inferiority for the primary safety endpoint.
The primary effectiveness endpoint, a composite of all death, disabling stroke and moderate or greater paravalvular aortic leakage (PVL) at one year, was lower with the LOTUS Valve system compared to the CoreValve platform (16.7% vs. 29.0%, p<0.001). The LOTUS Valve system also demonstrated non-inferiority to CoreValve platform for the primary safety endpoint which was a composite of all-cause mortality, stroke, life-threatening and major bleeding events, stage two or three acute kidney injury or major vascular complications through 30 days.
The pre-specified secondary endpoint demonstrated the LOTUS Valve system had significantly lower rates of moderate to severe PVL occurrences when compared to the CoreValve platform (2.0% vs. 11.1%, p<0.001).
"The excellent results seen in this large randomized trial, particularly the superior performance in efficacy and the continued demonstration of low PVL rates, further establish the advantages of the LOTUS Valve system," said Ted E. Feldman, M.D., director, Cardiac Catheterization Laboratory, NorthShore University HealthSystem in Evanston, Illinois, and co-investigator of the REPRISE III trial. "With the LOTUS Valve system, I have confidence that I can position the valve accurately in every case and achieve good outcomes for my patients."
REPRISE III is the first head-to-head pivotal study comparing two different TAVI platforms: the LOTUS Valve system and the CoreValve platform, including both CoreValve and EvolutR. It is a multi-center, randomized controlled trial that included 912 patients from the United States, Europe, Canada and Australia with severe aortic stenosis who were considered to be at high or extreme risk for surgical valve replacement.
"We are very excited by the performance of the LOTUS Valve system in this trial as it represents a crucial piece of clinical evidence for the LOTUS platform," said Ian Meredith, M.D., executive vice president and global chief medical officer, Boston Scientific. "We believe that these data, along with upcoming findings to be shared from the RESPOND and RESPOND Extension studies, can further illustrate the unique clinical benefits that this system offers physicians for the treatment of patients."
Aortic valve disease results in dysfunction of the aortic valve, one of the four valves that control the flow of blood in and out of the heart. Aortic valve stenosis is the process of thickening and stiffening of the valve, resulting in restricted valve opening and reduction in blood flow. Aortic stenosis is a common problem affecting approximately three percent of the population over age 65 and five percent of people older than 75. From the onset of aortic stenosis symptoms, the average survival rate is 50 percent at two years and 20 percent at five years.