Research In Brief

Everolimus vs. paclitaxel: A cost-effectiveness analysis would help determine whether greater reductions in myocardial infarction and target lesion revascularization rates with Abbott's Xience V everolimus-eluting stent - versus the less expensive paclitaxel-eluting stent - "warrant its routine use" in patients without diabetes, according to an editorial by University of Texas Health Science Center physicians Richard A. Lange and L. David Hillis published May 6 in the New England Journal of Medicine. The editorial accompanied publication of the already-revealed results of the 3,690-patient SPIRIT IV study, which showed that Xience outperformed Boston Scientific's Taxus Express2 paclitaxel stent, except in diabetics (1"The Gray Sheet" Sept. 28, 2009). For those patients, Lange and Hillis write, the paclitaxel stent, which costs about $300 less than the everolimus stent, "may be appropriate." In all patients, further studies are needed to determine whether second-generation stents like Xience are superior in reducing the incidence of stent thrombosis and MI when prasugrel (Lilly's Effient) is administered, they conclude