CLASP IID one year data confirms safety and efficacy of PASCAL system for degenerative mitral regurgitation – Edwards Life Sciences

Edwards Lifesciences Corporation announced one-year results from CLASP IID, the first randomized controlled trial that directly compares two contemporary mitral transcatheter edge-to-edge repair (TEER) therapies, as well as one-year results from the CLASP IID registry.

The studies confirm the clinical and quality-of-life benefits of mitral regurgitation (MR) reduction with the PASCAL system in a broad population of patients with degenerative mitral regurgitation (DMR). Results from the CLASP IID randomized trial and registry were presented as a late-breaking clinical trial session at the 35th Transcatheter Cardiovascular Therapeutics (TCT), the annual scientific symposium of the Cardiovascular Research Foundation, and simultaneously published in JACC: Cardiovascular Interventions.

Patients enrolled in the CLASP IID pivotal trial had significant symptomatic DMR and were determined to be at prohibitive surgical risk. Patients enrolled in the CLASP IID registry met those same criteria yet were deemed ineligible for randomization. One-year results from the CLASP IID randomized trial showed the PASCAL system achieved : i. Freedom from major adverse events rate of 84.7 percent at one year, and significant and sustained MR reduction, with 95.8 percent of patients achieving MR less than 2+ at one year. ii. Increasingly, the MR reduction goal with TEER is to achieve MR less than 1+ because contemporary evidence suggests reduced regurgitation may correlate with improved long-term patient outcomes. iii. At one year, 77.1 percent of PASCAL patients in the trial achieved a MR rate of less than 1+. The PASCAL system also showed sustained outcomes of high survival, low heart failure hospitalization and meaningful quality-of-life improvements.

“These data from the CLASP IID randomized trial and registry further advance mitral edge-to-edge repair as an important treatment option for a wide range of very sick patients who suffer with debilitating symptoms,” said Firas Zahr, MD, director of Interventional Cardiology and co-director of the Complex Heart Valve Program at Oregon Health & Science University and CLASP IID Study Investigator. “Patients receiving the PASCAL system experienced significant improvements in functional capacity and quality of life that were sustained for one year.”

The CLASP IID trial is a prospective randomized controlled trial comparing the safety and effectiveness of the PASCAL system to the MitraClip system. Results were reported on 300 patients with 2:1 randomization (204 PASCAL / 96 MitraClip), with clinical events committee and echo core lab adjudication. The CLASP IID registry enrolled 98 patients. The trial and registry included 57 sites in the US, Canada and Europe, with most clinical operators new to using the PASCAL system and all having experience with the MitraClip system.

“We are pleased that these one-year results affirm the safety and effectiveness of the PASCAL system and the benefits of TEER for this undertreated patient population,” said Daveen Chopra, Edwards’ corporate vice president, transcatheter mitral and tricuspid therapies. “Growing our body of clinical evidence in support of our patient-driven therapies is a high priority at Edwards, and we are committed to pursuing multiple pivotal trials in our efforts to transform treatment for a broad population of patients in need.”

As part of Edwards’ continued commitment to building robust real-world evidence, patients receiving the PASCAL Precision system in the US are enrolled in a post-market registry for five years. Additional ongoing studies of the PASCAL system include the single-arm CLASP trial and European post-market MiCLASP registry. The PASCAL Precision system is one of multiple transcatheter repair or replacement therapies in development by Edwards and is approved for degenerative mitral regurgitation in the US and Japan and has CE Mark for the treatment of mitral degenerative and functional regurgitation, and tricuspid regurgitation.

About TEER :Transcatheter Edge-to-Edge Repair (TEER) of the mitral valve is used in the treatment of MR. TEER approximates the anterior and posterior mitral valve leaflets by grasping them with a clasping device in an approach similar to a treatment developed in cardiac surgery called the Alfieri stitch.

See- “One-year Outcomes from the CLASP IID Randomized Trial for Degenerative Mitral Regurgitation”:Firas Zahr CLASP IID Pivotal Trial Investigator et. al. J Am Coll Cardiol Intv Oct 26, 2023 Epublished DOI: 10.1016/j.jcin.2023.10.002.