Medtronic (NYSE: MDT) announced that it
intends to seek U.S. Food and Drug Administration (FDA) approval for the use of
Cardiac Resynchronization Therapy (CRT) in certain mildly symptomatic heart failure
patients. CRT is a proven life-saving therapy for some patients with advanced stages of
heart failure (New York Heart Association Class III, IV); however it is not currently
approved for use in earlier stages, or mildly symptomatic patients.
"Results from large???scale studies like REVERSE suggest benefits with CRT for patients
with mild heart failure," said David Steinhaus, M.D., medical director of the Cardiac
Rhythm Disease Management business at Medtronic. "For some heart failure patients,
CRT appears to slow the progression of the disease, and delay time to first heart failure
hospitalization or death - which can have a great impact to the healthcare system."
In REVERSE, CRT used in combination with optimal medical therapy, including beta
blockers and ACE inhibitors or aldosterone???receptor blockers, led to a statistically
significant improvement in heart failure clinical composite score at 24 months, a
standard measurement that includes several clinical measures of heart failure status.
"We look forward to continued discussions with the FDA on the role CRT can
potentially play in heart failure treatment regimens for early stage heart failure
patients," Dr. Steinhaus said. "At Medtronic, our goal is to provide innovative solutions
to the most challenging healthcare problems, and we are hopeful that earlier
intervention with CRT will help both physicians and patients to better address this
serious and often debilitating condition."
Medtronic's decision precedes anticipated results from the fully enrolled Canadian
RAFT (Resynchronization / Defibrillation in Ambulatory Heart Failure Trial) study,
which is evaluating the impact of CRT on all???cause mortality and heart failure
hospitalization in NYHA Class II patients, as well as other industry trials that continue
to assess CRT for mildly symptomatic heart failure patients.
About Medtronic Heart Failure Research
Medtronic's continued leadership in heart failure research includes major support of
scientific research evaluating CRT treatment for a range of heart failure patients,
including:
- REVERSE: initiated in 2004, this is the first large???scale, global, randomized, doubleblind
study to suggest the benefits of CRT in mild heart failure patients or
asymptomatic patients who previously had heart failure symptoms.
- CARE???HF (Cardiac Resynchronization in Heart Failure): initiated in 2001, evaluated
NYHA Class III, IV patients for 18 months and demonstrated CRT improves
symptoms and reduces complications and risk of death.
- MIRACLE / MIRACLE ICD (Multicenter InSync / ICD Randomized Clinical
Evaluation) studies: initiated in 1998 and 1999, respectively, evaluated NYHA Class
III, IV patients for six months and demonstrated significant improvements in quality
of life and cardiac function.
Medtronic heart failure research studies currently underway include:
- BLOCK HF (Biventricular Versus Right Ventricular Pacing in Heart Failure Patients
With Atrioventricular Block) trial: initiated in 2003, is determining the value of CRT
in patients with AV block and at risk of developing worsening heart failure; trial
sites in the U.S. and Canada.
- IMPROVE HF (Improve the Use of Evidence???Based Heart Failure Therapies in the
Outpatient Setting): designed to quantify and improve quality of care for heart
failure patients by promoting the use of evidence???based, guideline???recommended
therapies.
- OptiVol Care Pathway: assessing whether more frequent (monthly vs. quarterly)
review of OptiVol® Fluid Status Monitoring patient data results in earlier clinical
intervention.
Source
Medtronic