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SURPASS-CVOT (N=13,165) noninferior on 3-point MACE (HR 0.92), with 4-point MACE HR 0.88 and all-cause death HR 0.84: Heerspink SURPASS-4 kidney post-hoc

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Evaluating these trial metrics through a biomechanical and neurotologic lens clarifies the precise clinical role for SPI-1005: It acts as a selective metabolic protector for auditory tissue hardware, yet it remains incapable of resolving mechanical endolymphatic pressure shifts or underlying sensory integration deficits

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