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Oral sirolimus with BMS may reduce in-stent restenosis
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A short-term regimen of oral sirolimus after bare-metal stent implantation yielded significant reductions of in-stent restenosis and target lesion revascularization, according to recent findings. Additionally, the rates of in-stent restenosis were similar to drug-eluting stents with the benefit of cost savings.
Neointimal hyperplasia may determine in-stent restenosis in individuals undergoing PCI, according to Tarun W. Dasari, MD, MPH, with the University of Oklahoma Health Sciences Center, Oklahoma City, and fellow study investigators. They added that DES improved on BMS in mitigating neointimal hyperplasia and reducing in-stent restenosis. In the current study, they aimed to build on recent research indicating that a short course of oral sirolimus after BMS may reduce this complication.
Tarun W. Dasari
The current systematic review investigated short-term oral sirolimus use with BMS in a cohort of 488 patients from four studies conducted between 2006 and 2010. Eligible analyses were culled from PubMed, Embase, Cochrane database review and Web of Science and compared oral sirolimus after BMS with BMS alone or DES.
In-stent restenosis served as the primary outcome, along with TLR and MACE.
Three of the studies involved comparison of BMS with sirolimus and BMS alone. Significant reduction in the primary outcome was reported among patients receiving sirolimus in these studies. Significant TLR reductions occurred at 6 to 12 months follow-up in two of these studies.
The fourth study included in the analysis involved a comparison of BMS plus oral sirolimus with DES. Oral sirolimus was associated with a nonsignificant decrease in TLR and a significant reduction in cost.
“Our systematic review demonstrates that early short-term systemic use of sirolimus after BMS resulted in a significant reduction in in-stent restenosis and TLR,” Dasari and colleagues concluded. “In addition, in-stent restenosis rates were comparable to DES with the added benefit of cost saving.”
Disclosure: The researchers report no relevant financial disclosures.
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