Bulwnkl,
This is not my endorsement or rejection of Inari, I just want to point out one thing:
Never, ever take the rosy headline of a biotech or medical device company’s trial results at face value.
You have to read every damn thing yourself and do your own research.
I’d like to think that this approach applies to EVERY stock we want to put in our portfolio, but I feel it is doubly true in the biotech/medical device sector.
Which is why I don’t bother investing in them - it’s just too much work, paired with heightened degrees of risks that other sectors don’t typically face, especially if you’re not highly attuned to the industry (I’m only boarded in internal medicine, so perhaps, if I had trained in heme-onc or some other specific fellowship, I’d have a greater inclination to go biotech stock picking).
To illustrate what I mean for Inari here:
The review article you posted says the death rate of diagnosed and treated PE is 8%.
Well, you can’t really compare that to Inari’s reported death rate of 0.2%.
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Inari’s reported 0.2% death rate in the headline is for 48 hours post procedure. Looks great, but the death rate should be higher the farther out you look post-procedure, whether it’s 30 days, 90 days, 1 year, etc.
Well, the review article doesn’t specify but I highly doubt the cited 8% death rate put a cut off at 48 hours after presentation. It’s probably not comparable at all by this metric alone. -
You should read Inari’s FLASH trial criteria: https://clinicaltrials.gov/ct2/show/NCT03761173
There is huge selection bias (as there always will be, for any procedure or medical device trial). Inari deliberately excludes patients expected to live less than 30 days. That’s going to massively deflate their death rate figures.
A lot of patients who die of a PE despite usual diagnosis and treatment, are going to fall into this category of life expectancy less than 30 days.
The patients nearest their end of life are often those with terminal cancer, already sick with major comorbidities in the ICU, etc and these are the patients who are most likely to get a massive PE and not survive, no matter what you do to them.
So, that 8% death rate in the review article isn’t going to exclude these sickest of the sick; it’s not fair to compare with Inari in this manner either. -
Inari’s FLASH trial criteria also exlcudes patients whose “imaging evidence that suggests, in the Investigator’s opinion, the subject is not appropriate for mechanical thrombectomy intervention”.
That’s more selection bias. The 8% review article death rate is not going to exclude those patients who can’t be helped with mechanical thrombectomy.
Again, I don’t know anything about Inari other than taking the couple minutes to look at the links you posted and a quick search to find Inari’s trial link, but I hope it makes sense to you why you can’t just immediately trust company headlines. A better way to find out if their device is “better” is to do a comprehensive review of all of Inari’s mechanical thrombectomy competitors’ trials and see if Inari really does beat the pack in the relevant endpoints, and if so, does their device costs make sense for hospitals to switch to using them.
Off the top of my head, I know the hospitals I work at uses Penumbra products for mechanical thrombectomy, so I would at minimum recommend you check their data out versus Inari.