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A Trial of Firesorb in Patients With Coronary Artery Disease: FUTURE-II (FUTURE-II)

Primary Purpose

Coronary Artery Disease

Status
Active
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Firesorb
XIENCE
Sponsored by
Shanghai MicroPort Medical (Group) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring Bioresorbable Vascular Scaffold

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

General Inclusion Criteria:

  1. 18-75 years of age, males or non-pregnant females;
  2. With silent ischemia evidence, patients with stable or unstable angina, or in patients with old myocardial infarction;
  3. Patients with indications for coronary artery bypass graft surgery;
  4. To understand the purpose of testing, voluntary and informed consent, patients undergoing invasive imaging follow-up.

Angiographic Inclusion Criteria:

  1. One or two de novo target lesions:

    1. If there is one target lesion, a second non-target lesion may be treated but the non-target lesion must be present in a different epicardial vessel, and must be treated first with a successful, uncomplicated result prior to randomization of the target lesion.
    2. If two target lesions are present, they must be present in different epicardial vessels and both must satisfy the angiographic eligibility criteria.
    3. The definition of epicardial vessels means the LAD, LCX and RCA and their branches. Thus, the patient must not have lesions requiring treatment in e.g. both the LAD and a diagonal branch.
  2. Target lesion(s) must be located in a native coronary artery with a visually estimated or quantitatively assessed % diameter stenosis (DS) of ≥ 50% and < 100% with a thrombolysis in myocardial infarction (TIMI) flow of ≥1 and one of the following: stenosis ≥ 70%, an abnormal functional test (e.g. fractional flow reserve, stress test), unstable angina or post-infarct angina. Lesion(s) must be located in a native coronary artery with RVD by visual estimation of ≥ 2.5 mm and ≤4.0 mm. Lesion(s) must be located in a native coronary artery with length by visual estimation of ≤ 25 mm.
  3. Each target lesion may be covered with one stent.

General Exclusion Criteria:

  1. Within 1 week of any acute myocardial infarction or myocardial enzymes did not return to normal;
  2. Implantation of stent in target vessel within 1 year , patients with planned intervention again within six months;
  3. Severe congestive heart failure (NYHA III and above) ,or left ventricular ejection fraction <40% (ultrasound or left ventricular angiography);
  4. Preoperative renal function serum creatinine >2.0mg/DL; receiving hemodialysis;
  5. Bleeding, active gastrointestinal ulcers, brain hemorrhage or subarachnoid hemorrhage and half year history of ischemic stroke, antiplatelet agents and would not allow an anticoagulant therapy contraindications patients undergoing antithrombotic therapy;
  6. Aspirin, clopidogrel, heparin, contrast agent, poly lactic acid polymer and rapamycin allergies;
  7. The patient's life expectancy is less than 12 months;
  8. Top participated in other drug or medical device and does not meet the primary study endpoint in clinical trials time frame;
  9. Researchers determine patient compliance is poor, unable to complete the study in accordance with the requirements;
  10. Heart transplantation patients;
  11. The unstable arrhythmia, such as high risk ventricular extrasystole and ventricular tachycardia;
  12. Cancer need chemotherapy;
  13. Immunosuppression and autoimmune diseases, planned or undergoing immunosuppressive therapy;
  14. Planning or being receiving long-term anticoagulant therapy, such as heparin, warfarin, etc;
  15. Within six months for elective surgery requires stopping aspirin, Clopidogrel patients;
  16. Blood test prompted platelet counts of less than 100x10E9/L or greater than 700x10E9/L, white blood cells than 3x10E9/L; known or suspected liver disease (such as hepatitis);
  17. Peripheral vascular disease, 6F catheter is not available.

Angiographic Exclusion Criteria:

  1. left main coronary artery disease;
  2. severe triple vessel lesion and required revascularization.

The following exclusion criteria apply to the target lesion(s) or target vessel(s):

  1. Aorto-ostial right coronary artery (RCA) lesion (within 3 mm of the ostium).
  2. Lesion located within 3 mm of the origin of the Left Anterior Descending Artery (LAD) or left circumflex artery (LCX).
  3. Lesion involving a bifurcation with a:

    1. side branch ≥ 2.5 mm in diameter, or
    2. side branch with diameter stenosis ≥ 50%, or
    3. side branch requiring guide wire, or
    4. side branch requiring dilatation.
  4. Anatomy proximal to or within the lesion that may impair delivery of Firesorb or XIENCE stent:

    1. Extreme angulation (≥ 90°) proximal to or within the target lesion.
    2. Excessive tortuosity (≥ two 45° angles) proximal to or within the target lesion.
    3. Moderate or heavy calcification proximal to or within the target lesion.
  5. Lesion or vessel involves a myocardial bridge.
  6. Vessel contains thrombus as indicated in the angiographic images or by IVUS or OCT.
  7. Vessel has been previously treated with a stent at any time prior to the index procedure such that the Firesorb or XIENCE would need to cross the stent to reach the target lesion.
  8. Vessel has been previously treated and the target lesion is within 5 mm proximal or distal to a previously treated lesion.
  9. Lesion which prevents successful balloon pre-dilatation, defined as full balloon expansion with the following outcomes:

    1. Residual %DS is a maximum of < 40% (per visual estimation), ≤ 20% is strongly recommended.
    2. TIMI Grade-3 flow (per visual estimation).
    3. No angiographic complications (e.g. distal embolization, side branch closure).
    4. No dissections National Heart Lung and Blood Institute (NHLBI) grade D-F.
    5. No chest pain lasting > 5 minutes.
    6. No ST depression or elevation lasting > 5 minutes.

Sites / Locations

  • Fu Wai Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Firesorb

XIENCE

Arm Description

Implantation of the Sirolimus Target Eluting Bioresorbable Vascular Scaffold (Firesorb)

Implantation of the XIENCE Everolimus Eluting Coronary Stent System

Outcomes

Primary Outcome Measures

In-segment Late Lumen Loss (LLL) (Queue 1)
In-segment late lumen loss is defined as the change in minimal lumen diameter (MLD) within the margins of the scaffold/stent and 5mm proximal and 5mm distal to the scaffold/stent from post-procedure to 1 year by angiography.

Secondary Outcome Measures

The percentage of intima coverage-strut (OCT subgroup)
The main secondary endpoint
Vasomotion (Queue 2)
The changes in average lumen diameter before and after intracoronary nitroglycerin
Acute Success-Device Success
Successful delivery and deployment of the assigned scaffold/stent at the intended target lesion and successful withdrawal of the delivery system with attainment of final in-scaffold/stent residual stenosis of less than 30% by visual.
Acute Success-Procedural Success
Achievement of final in-scaffold/stent residual stenosis of less than 30% by visual estimation with successful delivery and deployment of at least one assigned scaffold/stent at the intended target lesion and successful withdrawal of the delivery system for the target lesion without the occurrence of cardiac death, target vessel MI or repeat TLR.
Device-oriented composite endpoints (Target Lesion Failure)
Target Lesion Failure is defined as the composited endpoints of cardiac death,target vessel myocardial infarction and clinical driven-target lesion revascularization.
Patient-oriented clinical composite endpoint (PoCE)
Patient-oriented clinical composite endpoint is defined as all cause death, all myocardial infarction, and any revascularization.
Death (Cardiac, Vascular, Non-cardiovascular)
Cardiac death (CD): Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment. Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Myocardial Infarction (MI)
Attributable to target vessel (TV-MI) Not attributable to target vessel (NTV-MI)
Target Vessel Revascularization (TVR)
Ischemia-driven TVR (ID-TVR) Not ischemia-driven TVR (NID-TVR)
Target Lesion Revascularization (TLR)
Ischemia-driven TLR (ID-TLR) Not ischemia-driven TLR (NID-TLR)
Any Revascularization
Scaffold/Stent Thrombosis (per ARC definition)
Timing (acute, sub-acute, late and very late) Evidence (Definite and Probable)
Site Diagnosed Angina (SDA)
Defined as the study unit by collecting Seattle angina questionnaire (SAQ), doctor angina questionnaire and research units of AE reports incidence of angina pectoris (excludes angina pectoris 0-7 days after index procedure ).
Minimum Lumen Diameter (MLD)
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
percentage of diameter stenosis (%DS)
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Angiographic Binary Restenosis (ABR)
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Late Lumen Loss (LLL)
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Acute Stent Recoil
Descriptive analysis of morphometric, lesion composition and scaffold strut data obtained with OCT
OCT endpoint

Full Information

First Posted
August 31, 2016
Last Updated
October 23, 2023
Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02890160
Brief Title
A Trial of Firesorb in Patients With Coronary Artery Disease: FUTURE-II
Acronym
FUTURE-II
Official Title
A Randomized Trial of the Firesorb Sirolimus Target Eluting Bioresorbable Vascular Scaffold in Patients With Coronary Artery Disease: FUTURE-II
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 24, 2017 (Actual)
Primary Completion Date
October 31, 2020 (Actual)
Study Completion Date
October 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The FUTURE-II study is a confirmative clinical trial for Sirolimus Target Eluting Bioresorbable Vascular Scaffold (Firesorb) after the feasibility and safety of the device has been preliminary confirmed in a small-scale First-in-Man clinical trial.
Detailed Description
This study is a prospective, multicenter, single-blind, randomized controlled trial in patients with coronary artery disease caused by up to two de novo native coronary artery lesions in separate epicardial vessels. The goal is to evaluate the safety and effectiveness of Firesorb to support the approval of the Chinese Food and Drug Administration (CFDA) for this product. The Abbott's XIENCE Everolimus-eluting Coronary Stent System is selected as the control device. 430 subjects will be recruited. All subjects will be 1:1 randomly assigned to experimental group and control group. All subjects will undergo clinical follow-up at 1-month, 6-month, 1-year, 2-year, 3-year, 4-year and 5-year post-index procedure. All subjects will undergo angiographic follow-up at 1-year post-index procedure; of which 3-5 centers will be specified as a subgroup to complete OCT follow-up (n=80, 40 each in test and control group).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease
Keywords
Bioresorbable Vascular Scaffold

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
430 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Firesorb
Arm Type
Experimental
Arm Description
Implantation of the Sirolimus Target Eluting Bioresorbable Vascular Scaffold (Firesorb)
Arm Title
XIENCE
Arm Type
Active Comparator
Arm Description
Implantation of the XIENCE Everolimus Eluting Coronary Stent System
Intervention Type
Device
Intervention Name(s)
Firesorb
Intervention Description
Sirolimus Target Eluting Bioresorbable Vascular Scaffold
Intervention Type
Device
Intervention Name(s)
XIENCE
Intervention Description
Everolimus Eluting Coronary Stent System
Primary Outcome Measure Information:
Title
In-segment Late Lumen Loss (LLL) (Queue 1)
Description
In-segment late lumen loss is defined as the change in minimal lumen diameter (MLD) within the margins of the scaffold/stent and 5mm proximal and 5mm distal to the scaffold/stent from post-procedure to 1 year by angiography.
Time Frame
1 year after index procedure
Secondary Outcome Measure Information:
Title
The percentage of intima coverage-strut (OCT subgroup)
Description
The main secondary endpoint
Time Frame
1 year after index procedure
Title
Vasomotion (Queue 2)
Description
The changes in average lumen diameter before and after intracoronary nitroglycerin
Time Frame
2 year after index procedure
Title
Acute Success-Device Success
Description
Successful delivery and deployment of the assigned scaffold/stent at the intended target lesion and successful withdrawal of the delivery system with attainment of final in-scaffold/stent residual stenosis of less than 30% by visual.
Time Frame
From the start of index procedure to end of index procedure
Title
Acute Success-Procedural Success
Description
Achievement of final in-scaffold/stent residual stenosis of less than 30% by visual estimation with successful delivery and deployment of at least one assigned scaffold/stent at the intended target lesion and successful withdrawal of the delivery system for the target lesion without the occurrence of cardiac death, target vessel MI or repeat TLR.
Time Frame
At time of procedure up to 7 days in hospital
Title
Device-oriented composite endpoints (Target Lesion Failure)
Description
Target Lesion Failure is defined as the composited endpoints of cardiac death,target vessel myocardial infarction and clinical driven-target lesion revascularization.
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Patient-oriented clinical composite endpoint (PoCE)
Description
Patient-oriented clinical composite endpoint is defined as all cause death, all myocardial infarction, and any revascularization.
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Death (Cardiac, Vascular, Non-cardiovascular)
Description
Cardiac death (CD): Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment. Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Myocardial Infarction (MI)
Description
Attributable to target vessel (TV-MI) Not attributable to target vessel (NTV-MI)
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Target Vessel Revascularization (TVR)
Description
Ischemia-driven TVR (ID-TVR) Not ischemia-driven TVR (NID-TVR)
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Target Lesion Revascularization (TLR)
Description
Ischemia-driven TLR (ID-TLR) Not ischemia-driven TLR (NID-TLR)
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Any Revascularization
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Scaffold/Stent Thrombosis (per ARC definition)
Description
Timing (acute, sub-acute, late and very late) Evidence (Definite and Probable)
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Site Diagnosed Angina (SDA)
Description
Defined as the study unit by collecting Seattle angina questionnaire (SAQ), doctor angina questionnaire and research units of AE reports incidence of angina pectoris (excludes angina pectoris 0-7 days after index procedure ).
Time Frame
1 month,6 months,1 year,2 years,3 years,4 years and 5 years after index procedure
Title
Minimum Lumen Diameter (MLD)
Description
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Time Frame
1 year and 2 years after index procedure
Title
percentage of diameter stenosis (%DS)
Description
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Time Frame
1 year and 2 years after index procedure
Title
Angiographic Binary Restenosis (ABR)
Description
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Time Frame
1 year and 2 years after index procedure
Title
Late Lumen Loss (LLL)
Description
Including in-scaffold/stent, in-segment lesion, the proximal 5mm of stent, and the distal 5mm of stent.
Time Frame
1 year and 2 years after index procedure
Title
Acute Stent Recoil
Time Frame
Immediately after index procedure
Title
Descriptive analysis of morphometric, lesion composition and scaffold strut data obtained with OCT
Description
OCT endpoint
Time Frame
1 year and 2 years after index procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria: 18-75 years of age, males or non-pregnant females; With silent ischemia evidence, patients with stable or unstable angina, or in patients with old myocardial infarction; Patients with indications for coronary artery bypass graft surgery; To understand the purpose of testing, voluntary and informed consent, patients undergoing invasive imaging follow-up. Angiographic Inclusion Criteria: One or two de novo target lesions: If there is one target lesion, a second non-target lesion may be treated but the non-target lesion must be present in a different epicardial vessel, and must be treated first with a successful, uncomplicated result prior to randomization of the target lesion. If two target lesions are present, they must be present in different epicardial vessels and both must satisfy the angiographic eligibility criteria. The definition of epicardial vessels means the LAD, LCX and RCA and their branches. Thus, the patient must not have lesions requiring treatment in e.g. both the LAD and a diagonal branch. Target lesion(s) must be located in a native coronary artery with a visually estimated or quantitatively assessed % diameter stenosis (DS) of ≥ 50% and < 100% with a thrombolysis in myocardial infarction (TIMI) flow of ≥1 and one of the following: stenosis ≥ 70%, an abnormal functional test (e.g. fractional flow reserve, stress test), unstable angina or post-infarct angina. Lesion(s) must be located in a native coronary artery with RVD by visual estimation of ≥ 2.5 mm and ≤4.0 mm. Lesion(s) must be located in a native coronary artery with length by visual estimation of ≤ 25 mm. Each target lesion may be covered with one stent. General Exclusion Criteria: Within 1 week of any acute myocardial infarction or myocardial enzymes did not return to normal; Implantation of stent in target vessel within 1 year , patients with planned intervention again within six months; Severe congestive heart failure (NYHA III and above) ,or left ventricular ejection fraction <40% (ultrasound or left ventricular angiography); Preoperative renal function serum creatinine >2.0mg/DL; receiving hemodialysis; Bleeding, active gastrointestinal ulcers, brain hemorrhage or subarachnoid hemorrhage and half year history of ischemic stroke, antiplatelet agents and would not allow an anticoagulant therapy contraindications patients undergoing antithrombotic therapy; Aspirin, clopidogrel, heparin, contrast agent, poly lactic acid polymer and rapamycin allergies; The patient's life expectancy is less than 12 months; Top participated in other drug or medical device and does not meet the primary study endpoint in clinical trials time frame; Researchers determine patient compliance is poor, unable to complete the study in accordance with the requirements; Heart transplantation patients; The unstable arrhythmia, such as high risk ventricular extrasystole and ventricular tachycardia; Cancer need chemotherapy; Immunosuppression and autoimmune diseases, planned or undergoing immunosuppressive therapy; Planning or being receiving long-term anticoagulant therapy, such as heparin, warfarin, etc; Within six months for elective surgery requires stopping aspirin, Clopidogrel patients; Blood test prompted platelet counts of less than 100x10E9/L or greater than 700x10E9/L, white blood cells than 3x10E9/L; known or suspected liver disease (such as hepatitis); Peripheral vascular disease, 6F catheter is not available. Angiographic Exclusion Criteria: left main coronary artery disease; severe triple vessel lesion and required revascularization. The following exclusion criteria apply to the target lesion(s) or target vessel(s): Aorto-ostial right coronary artery (RCA) lesion (within 3 mm of the ostium). Lesion located within 3 mm of the origin of the Left Anterior Descending Artery (LAD) or left circumflex artery (LCX). Lesion involving a bifurcation with a: side branch ≥ 2.5 mm in diameter, or side branch with diameter stenosis ≥ 50%, or side branch requiring guide wire, or side branch requiring dilatation. Anatomy proximal to or within the lesion that may impair delivery of Firesorb or XIENCE stent: Extreme angulation (≥ 90°) proximal to or within the target lesion. Excessive tortuosity (≥ two 45° angles) proximal to or within the target lesion. Moderate or heavy calcification proximal to or within the target lesion. Lesion or vessel involves a myocardial bridge. Vessel contains thrombus as indicated in the angiographic images or by IVUS or OCT. Vessel has been previously treated with a stent at any time prior to the index procedure such that the Firesorb or XIENCE would need to cross the stent to reach the target lesion. Vessel has been previously treated and the target lesion is within 5 mm proximal or distal to a previously treated lesion. Lesion which prevents successful balloon pre-dilatation, defined as full balloon expansion with the following outcomes: Residual %DS is a maximum of < 40% (per visual estimation), ≤ 20% is strongly recommended. TIMI Grade-3 flow (per visual estimation). No angiographic complications (e.g. distal embolization, side branch closure). No dissections National Heart Lung and Blood Institute (NHLBI) grade D-F. No chest pain lasting > 5 minutes. No ST depression or elevation lasting > 5 minutes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Runlin Gao, MD
Organizational Affiliation
Fu Wai Hospital & National Center for Cardiovascular Diseases in China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fu Wai Hospital
City
Peking
State/Province
Beijing
ZIP/Postal Code
100037
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34238555
Citation
Song L, Xu B, Chen Y, Zhou Y, Jia S, Zhong Z, Su X, Ma Y, Zhang Q, Liu J, Wang Y, Guan C, Zheng M, Qiao S, Gao R; FUTURE-II Trial Investigators. Thinner Strut Sirolimus-Eluting BRS Versus EES in Patients With Coronary Artery Disease: FUTURE-II Trial. JACC Cardiovasc Interv. 2021 Jul 12;14(13):1450-1462. doi: 10.1016/j.jcin.2021.04.048. Epub 2021 May 18.
Results Reference
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A Trial of Firesorb in Patients With Coronary Artery Disease: FUTURE-II

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