LEADERS FREE IV (RCT): BioFreedom™ Ultra vs BioFreedom™ in HBR Patients

Biosensors International

Status: Enrolling

Conditions: Coronary Artery Disease; Unstable Angina; Acute Coronary Syndrome; Silent Ischemia; Chronic Stable Angina

Treatments: Device: BioFreedom™ Ultra cobalt-chromium Biolimus A9™-coated stent; Device: BioFreedom™ stainless steel Biolimus A9™-coated stent

Study type: Interventional

Funder types: Industry

Identifiers

NCT06657326

24-AP-01

Details and patient eligibility

About

This study aims to demonstrate that the BioFreedom™ Ultra Drug Coated Stent (DCS) is non-inferior to the BioFreedom™ DCS, with respect to in-stent late lumen loss, and that it has safety characteristics similar to the BioFreedom™ DCS.

Full description

The LEADERS FREE IV trial is conducted to evaluate of the efficacy (QCA) and safety of the BioFreedom™ Ultra Drug Coated Stent in patients with High Bleeding Risk (HBR) and coronary artery disease undergoing Percutaneous Coronary Intervention.

It is a prospective, multi-center, single blind (to patient), randomized, comparator trial, designed to randomize 444 HBR patients at approximately up to 7 centers in Malaysia.

The primary objective is to confirm non-inferiority of the BioFreedom™ Ultra stent compared to BioFreedom™ DCS as measured by the difference in angiographically measured late lumen loss at 9 months, and the main secondary objective is to assess safety as measured by TLF and ST. 444 patients will be randomized 1:1 to either stent, allowing for a direct comparison, and will be followed up to 5 years to measure for late TLF and ST events.

Enrollment: 444 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients at high bleeding risk (HBR) with an indication for PCI who can tolerate at least one month of DAPT. This includes patients with stable angina, silent ischemia, acute coronary syndromes (ACS) (STEMI and NSTEMI), de novo lesions in native arteries with diameter stenosis >70% by visual estimation and evidence of ischemia in the territory of the target vessel(s).
2. Patients meet ARC-HBR definition i.e at least 1 major or 2 minor criteria.

Exclusion criteria

1. Pregnant and breastfeeding women

2. Age <18 years old

3. Patients lacking capacity (i.e. patients suffering from dementia and others) to provide informed consent

4. Patients expected not to comply with 1 month DAPT

5. Active bleeding at the time of inclusion

6. Procedure requires the use of non-study stents, or alternative therapeutic options not followed by stent implantation (angioplasty only, atherectomy only)

7. Number of target lesions >2

8. Patient requires a stent of diameter <2.25mm

9. Patient requires a stent of diameter >4.0mm

10. Isolated ostial lesions within 3 mm of the origin of LAD or LCx (left main lesions involving the ostia of the LAD and/or LCx are eligible)

11. Patient has known left ventricular ejection fraction (LVEF) <30% (LVEF may be obtained at the time of the index procedure if the value is unknown and the investigator believes it is necessary)

12. Patient with chronic total occlusion(s) as target lesion(s)

13. Severe calcification that might prevent sufficient expansion of the DES, unless pre-treated with a plaque modification device such as cutting balloon, scoring balloon or intravascular lithotripsy.

    Note: Use of rotational or orbital atherectomy is also permitted.

14. Cardiogenic shock

15. Compliance with long-term single anti-platelet therapy unlikely

16. Known hypersensitivity or contraindication to aspirin, clopidogrel (or to any other P2Y12 inhibitor if applicable), cobalt chromium, stainless steel, zinc, Biolimus A9™ or a sensitivity to contrast media, which cannot be adequately pre-medicated

17. Any PCI during the previous 12 months

18. Participation in another clinical study (12 months after index procedure)

19. Patients with a life expectancy of <12 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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444 participants in 2 patient groups

BioFreedom™ Ultra DCS

Experimental group

Description:

Coronary artery disease patients with high-bleeding risk (HBR) will receive the BioFreedom™ Ultra stent if randomized to this arm (1:1 ratio)

Treatment:

Device: BioFreedom™ Ultra cobalt-chromium Biolimus A9™-coated stent

BioFreedom™ DCS

Active Comparator group

Description:

Coronary artery disease patients with high-bleeding risk (HBR) will receive the BioFreedom™ stent if randomized to this arm (1:1 ratio)

Treatment:

Device: BioFreedom™ stainless steel Biolimus A9™-coated stent