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Antibody-coated stents: Indication of disadvantages
Date:11/14/2012

ely used for patients at high risk of restenosis. The second generation of stents were coated and released small quantities of drugs (drug-eluting stents, DES). These drugs are meant to inhibit cell growth and thus avoid restenosis and the need for revascularization.

On the other hand, this coating delays incorporation of the stent, thus increasing the risk of thrombosis. Therefore patients with a DES must generally take antithrombotic drugs for at least 12 months after the operation. The active substances acetylsalicylic acid (ASS) and clopidogrel - so called platelet inhibitors - are most frequently used.

Antibody-stents are intended to reduce the use of anticoagulants

The third generation of stents act by using specific antibodies to stimulate cells growing into the vascular wall to form epithelium. This is supposed to accelerate the incorporation of the wire network and reduce the risk of thrombosis. The manufacturer claims that this greatly shortens the period for which antithrombotic drugs must be taken, thus helping to avoid the side effect of an increased tendency to bleed and also helping to reduce costs.

Two of three studies susceptible to bias

Three randomized controlled trials (RCTs) were available to IQWiG. Two studies compared antibody-stents with DES; one study compared antibody-stents with BMS. One DES study and one BMS study had only a few participants and were prematurely discontinued. These discontinuations were not planned, i.e. the criteria for stopping the studies had not been specified before the start of the studies. Moreover, it was unclear in one of the studies whether the randomized allocation to the two treatment groups was adequately concealed. These studies were thus highly susceptible to bias and the results can only be used to a limited extent.

In accordance with the mechanism of action of antibody-stents, the patients in all three studies were only given clopid
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Contact: Anna-Sabine Ernst
presse@iqwig.de
0049-221-356-850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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