Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives

Bibliographic Details
Title: Paclitaxel-Coated Versus Sirolimus-Coated Eluting Balloons for Percutaneous Coronary Interventions: Pharmacodynamic Properties, Clinical Evidence, and Future Perspectives
Authors: Filippo Luca Gurgoglione, Mattia De Gregorio, Giorgio Benatti, Davide Donelli, Luigi Vignali, Emilia Solinas, Iacopo Tadonio, Andrea Denegri, Marco Covani, Gabriella Dallaglio, Bernardo Cortese, Giampaolo Niccoli
Source: Future Pharmacology, Vol 4, Iss 4, Pp 775-787 (2024)
Publisher Information: MDPI AG, 2024.
Publication Year: 2024
Collection: LCC:Therapeutics. Pharmacology
Subject Terms: drug-coated balloon, paclitaxel, sirolimus, angioplasty, coronary artery disease, peripheral artery disease, Therapeutics. Pharmacology, RM1-950
More Details: Drug-coated balloons (DCBs) have emerged as an increasingly valuable option for the treatment of coronary artery disease (CAD). Percutaneous coronary intervention (PCI) with DCBs enables the localized delivery of antiproliferative drugs directly to the target coronary lesion, avoiding the need for permanent scaffold implantation. Historically, paclitaxel-coated balloons (PCBs) have been the most used device in this context. Paclitaxel interferes with intracellular microtubule function, leading to cell cycle arrest. However, its cytotoxicity at a higher dosage and narrow therapeutic range has raised some safety concerns. To address these issues, sirolimus-coated balloons (SCBs) have been introduced as an alternative. Sirolimus acts as a cytostatic agent with potent anti-inflammatory and antiproliferative properties and is characterized by a wider therapeutic range, potentially offering a safer profile. Several experimental and clinical studies comparing the safety and efficacy of PCBs versus SCBs have yielded mixed results. Recently, a novel DCB (SirPlux Duo), which simultaneously releases both paclitaxel and sirolimus, has been tested in a porcine coronary model with promising results. In this review, we will elucidate the mechanisms of action of paclitaxel and sirolimus, examine contemporary preclinical and clinical evidence comparing PCB and SCB angioplasty, and discuss novel devices that may enhance the safety and efficacy of PCI with DCBs.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2673-9879
Relation: https://www.mdpi.com/2673-9879/4/4/41; https://doaj.org/toc/2673-9879
DOI: 10.3390/futurepharmacol4040041
Access URL: https://doaj.org/article/d074ad2694c946a5976b9d78f4800d2d
Accession Number: edsdoj.074ad2694c946a5976b9d78f4800d2d
Database: Directory of Open Access Journals
More Details
ISSN:26739879
DOI:10.3390/futurepharmacol4040041
Published in:Future Pharmacology
Language:English