In a head-to-head competition between the two drug-eluting stents on the market, two studies published in this week's New England Journal of Medicine give a slight clinical edge to Johnson & Johnson's sirolimus-eluting stent over Boston Scientific's paxlitaxel-eluting stent.
The first study compared the stents in 1,012 patients undergoing angioplasty in Europe and found the sirolimus-eluting stents resulted in fewer major adverse cardiac events primarily by reducing the rate of restenosis, or a renarrowing of the coronary arteries. The second study compared the two stents in 250 European heart patients with diabetes and similarly found that use of the sirolimus-eluting stent also suggested a reduced risk of restenosis.
In an accompanying editorial, David Moliterno of the University of Kentucky at Lexington noted that the J&J stent may have "an angiographic and clinical edge" over the Boston Scientific version, but the Boston Scientific version "holds an edge on availability, deliverability and cost." The contest may be a moot point -- a large-scale trial may definitively settle the contest, he said. But he added that a second generation is already well under way.