ライフサイエンスコーパス: alteplase

1 Intravenous tPA (recombinant alteplase).

2 ecting good stroke outcome in patients given alteplase.

3 r thrombolytic therapy with streptokinase or alteplase.

4 Intravenous thrombolysis with alteplase.

5 resolve with thrombolytic treatment, such as alteplase.

6 us alteplase and six received intra-arterial alteplase.

7 se and 4.5 h (3.8-24.0 h) for intra-arterial alteplase.

8 do not improve on treatment with intravenous alteplase.

9 pectively, compared with 0%, 0%, and 23% for alteplase.

10 apleural instillation of either urokinase or alteplase.

11 ow when combined with half the usual dose of alteplase.

12 of coronary thrombolysis with reteplase and alteplase.

13 th the thrombolytic agents streptokinase and alteplase.

14 = 0.003) and thrombin (p = 0.009) than after alteplase.

15 higher at 24 h after thrombolysis than after alteplase.

16 tion, with heparin, aspirin, and accelerated alteplase.

17 1.13-5.94; P=0.032) than those treated with alteplase.

18 treptokinase and non-accelerated infusion of alteplase.

19 675 (14%) of the enrollees were treated with alteplase.

20 s to be tested as a potential alternative to alteplase.

21 n to the substantial efficacy of intravenous alteplase.

22 e tenecteplase 0.25 mg/kg (maximum 25 mg) or alteplase 0.9 mg/kg (maximum 90 mg).

23 andard medical care or image-guided MIS plus alteplase (0.3 mg or 1.0 mg every 8 h for up to nine dos

24 we randomly assigned 75 patients to receive alteplase (0.9 mg per kilogram of body weight) or tenect

25 Stroke Scale score change: tenecteplase, 6; alteplase, 1; P<0.001) and better late independent recov

26 e enrolled, of whom 238 received intravenous alteplase (120 in the intervention group and 118 in the

27 The most promising regimen was 50 mg of alteplase (15-mg bolus; infusion of 35 mg over 60 minute

28 rate of stroke in women after treatment with alteplase (2.0% vs 1.9% with streptokinase and intraveno

29 .97), and those not eligible for intravenous alteplase (2.43, 1.30-4.55).

30 Stroke Scale score change: tenecteplase, 7; alteplase, 2; P=0.018) and less parenchymal hematoma (2

31 lone or in combination with reduced doses of alteplase (20 to 65 mg) or streptokinase (500 000 U to 1

32 ibrinolytic assignment (streptokinase, 4.1%; alteplase, 4.3%; reteplase, 4.5%; combined streptokinase

33 reteplase, 4.5%; combined streptokinase and alteplase, 4.4%; P=0.55).

34 dian NIHSS 7 (range 1-30), 38 (46%) received alteplase, 41 (49%) had died or were dependent at 3 mont

35 We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, i

36 regimens as reperfusion therapy in STEMI and alteplase (accelerated infusion), tenecteplase, and rete

37 triaging, off-hour presentation, intravenous alteplase administration, use of general anesthesia, and

38 The ability to cryopreserve alteplase aliquots makes it an economically reasonable a

39 jor hemorrhage were 6% in patients receiving alteplase alone (n=235), 3% with abciximab alone (n=32),

40 o patients who were treated with intravenous alteplase alone from the International Stroke Perfusion

41 inutes for patients treated with accelerated alteplase alone was 57% compared with 32% for abciximab

42 litaire FR stent retriever, as compared with alteplase alone, improved reperfusion, early neurologic

43 tients and 132 matched controls treated with alteplase alone.

44 on) stent retriever or to continue receiving alteplase alone.

45 clinical outcomes compared with intravenous alteplase alone.

46 However, alteplase also increases the risk of intracerebral haemo

47 Primary treatment success was 98% for alteplase and 100% for urokinase, with no major complica

48 en in 96 (5.2%) of 1850 patients assigned to alteplase and 18 (1.0%) of 1820 controls, with no clear

49 was 3.3 h (range 2.0-52.0 h) for intravenous alteplase and 4.5 h (3.8-24.0 h) for intra-arterial alte

50 Of 146 pooled patients, 71 received alteplase and 75 received tenecteplase.

51 he majority of patients received intravenous alteplase and concomitant full-dose heparin.

52 REACH is presently being used to give alteplase and guide acute stroke care in eight rural com

53 tudies showed rapid clearance of circulating alteplase and recovery of plasminogen activator inhibito

54 eceived alteplase: nine received intravenous alteplase and six received intra-arterial alteplase.

55 Multiple variables were compared for the alteplase and urokinase groups by using univariate and m

56 t in the use of thrombolytic treatment (with alteplase) and lipid testing.

57 target occlusion, infarct core, pretreatment alteplase), and the collateral score.

58 features, adherence to adult guidelines for alteplase, and outcomes.

59 erapy in STEMI (streptokinase, tenecteplase, alteplase, and reteplase) were included.

60 ssociated illnesses, after thrombolysis with alteplase, and when therapies were initiated outside app

61 uate the dose and the safety and efficacy of alteplase are needed in childhood stroke.

62 Cryopreserved 1-mg/mL aliquots of alteplase are safe and effective in the clearance of occ

63 However, the practicality of using alteplase as the thrombolytic of choice for this indicat

64 All patients received accelerated alteplase, aspirin, and intravenous heparin infusion; al

65 as Integrilin, is combined with accelerated alteplase, aspirin, and intravenous heparin.

66 incoming stroke patients; (2) administering alteplase at the computed tomography (CT) scanner; and (

67 longer among patients receiving intravenous alteplase at the referring hospital (drip and ship) vers

68 ed plasma clots with either streptokinase or alteplase, at therapeutic levels, increased the availabl

69 han waiting for an assessment of response to alteplase, because minimising time to reperfusion is the

70 tients (89.0%) were treated with intravenous alteplase before randomization.

71 ed efficacy and safety profile compared with alteplase, benefits possibly exaggerated in patients wit

72 tember 2, 1995, and March 27, 1998, and with alteplase between March 30, 1998, and January 2, 2002.

73 A focus on extending the time window for alteplase beyond 4.5 hours has encumbered substantial re

74 in addition to thrombolysis with intravenous alteplase, but benefits were also reported in patients i

75 clots using surgical aspiration followed by alteplase clot irrigation.

76 ts (35 assigned tenecteplase and 36 assigned alteplase) contributing to the primary endpoint, no sign

77 itially to either 100 mg of accelerated-dose alteplase (control) or abciximab (bolus 0.25 mg/kg and 1

78 [AUC], 0.89; 95% CI, 0.84, 0.94), whereas in alteplase controls the optimal ischemic core threshold r

79 tine extraventricular drain, irrigation with alteplase did not substantially improve functional outco

80 alfimeprase doses were more successful than alteplase during the first 15 and 30 minutes of treatmen

81 In all study patients, the use of alteplase either did not achieve revascularization or wa

82 Intrapleural fibrinolysis with urokinase or alteplase facilitates thoracostomy tube drainage of para

83 current practices and results of the use of alteplase for acute arterial ischaemic stroke in childre

84 short-term outcome in children treated with alteplase for acute arterial ischaemic stroke who were e

85 ommon data elements from six other trials of alteplase for acute stroke (2775 patients).

86 e reports and with guidelines for the use of alteplase for adult stroke.

87 ogram) was superior to the lower dose and to alteplase for all efficacy outcomes, including absence o

88 linical trials of tenecteplase compared with alteplase for the treatment of acute ischemic stroke, 1

89 ted randomised phase 3 trials of intravenous alteplase for treatment of acute ischaemic stroke for wh

90 eptokinase and Tissue plasminogen activator (alteplase) for Occluded coronary arteries (GUSTO I) and

91 in the Global Use of Streptokinase and TPA (alteplase) for Occluded Coronary arteries (GUSTO)-I tria

92 Thrombolysis with streptokinase or alteplase further increased both parameters, which peake

93 In most countries, alteplase given within 4.5 h of onset is the only approv

94 e was similar in each group (good outcome in alteplase group 48% vs saline 45%; risk ratio [RR] 1.06

95 analysis from 246 of 249 participants in the alteplase group and 245 of 251 participants in the place

96 15, 500 patients were randomised: 249 to the alteplase group and 251 to the saline group.

97 ompleted follow-up: 54 (56%) in the MIS plus alteplase group and 42 (44%) in the standard medical car

98 52 were assigned to the alteplase group and 52 to tenecteplase.

99 aemorrhages were more common in the MIS plus alteplase group than in the standard medical care group

100 mortality at 90 days was 608 (17.9%) in the alteplase group versus 556 (16.5%) in the control group

101 Symptomatic bleeding (six [2%] in the alteplase group vs five [2%] in the saline group; RR 1.2

102 initely related to drug treatment; 16 in the alteplase group, five were considered drug-related).

103 l improvement (P<0.001) at 24 hours than the alteplase group.

104 (0.92-1.61) for 271-360 min in favour of the alteplase group.

105 r the tenecteplase group vs 68% [23] for the alteplase group; mean difference 1.3% [95% CI -9.6 to 12

106 did not differ between the tenecteplase and alteplase groups.

107 tween the standard medical care and MIS plus alteplase groups: 30 day mortality (four [9.5%, 95% CI 2

108 Participants allocated to alteplase had a significantly higher hazard of death dur

109 Alteplase has been reported as an efficacious alternativ

110 mbinant tissue plasminogen activator (rt-PA, alteplase) improved functional outcome in patients treat

111 Use of alteplase improves outcome in some patients with stroke.

112 Randomised trials have shown that alteplase improves the odds of a good outcome when deliv

113 own, STAT stroke protocol, and administering alteplase in CT are associated with lower DTN time.

114 erapy with tenecteplase would be superior to alteplase in improving functional outcomes in the group

115 etter reperfusion and clinical outcomes than alteplase in patients with stroke who were selected on t

116 following factors to be significant: giving alteplase in the CT (32% decrease in DTN time, 95% confi

117 The increase in use of alteplase in the target population was significant, but

118 th stroke who were admitted and treated with alteplase increased between the pre-intervention and pos

119 Alteplase increased the odds of a good stroke outcome, w

120 Alteplase increased the odds of type 2 parenchymal haemo

121 Children with acute stroke received alteplase infrequently and at time intervals that often

122 a fibrin-binding thrombolytic agent such as alteplase is an alternative to continuous-infusion throm

123 Alteplase is effective for treatment of acute ischaemic

124 However, the recanalisation rate with alteplase is modest.

125 ery occlusion on a background of intravenous alteplase is safe, improves excellent clinical outcomes

126 Intravenous alteplase is the only approved treatment for acute ische

127 th and disability worldwide, and intravenous alteplase is the only proven effective treatment in the

128 direct intraclot lacing of the thrombus with alteplase (maximum daily dose, 50 mg per leg per day; ma

129 onset in 3670 patients randomly allocated to alteplase (n=1850) or to placebo (n=1820).

130 troke enrolled in the IPSS, 15 (2%) received alteplase: nine received intravenous alteplase and six r

131 t hoc analysis of patients who also received alteplase, NXY-059 was associated with a lower incidence

132 Intracranial haemorrhage after alteplase occurred in four of 15 patients, although none

133 This improvement in reperfusion with alteplase occurred without an increase in the risk of ma

134 We report the effect of intravenous alteplase on long-term survival after ischaemic stroke o

135 The effect of alteplase on patient survival after ischaemic stroke is

136 The effects of reteplase and alteplase on platelet aggregation and major surface anti

137 have expressed concerns about the effect of alteplase on survival.

138 ine the proportional and absolute effects of alteplase on the risks of intracerebral haemorrhage, mor

139 of time to treatment with intravenous rt-PA (alteplase) on therapeutic benefit and clinical risk by a

140 n the endovascular-therapy group than in the alteplase-only group (median, 100% vs. 37%; P<0.001).

141 mg alteplase plus abciximab group versus the alteplase-only group at both 60 minutes (72% versus 43%;

142 receive up to 12 doses, 8 h apart of 1 mg of alteplase or 0.9% saline via the extraventricular drain.

143 AMI before and after reperfusion with either alteplase or reteplase or reduced doses of these agents

144 When combined with reduced doses of either alteplase or reteplase, abciximab achieved 91% and 83% i

145 enhance patient selection are investigating alteplase, other thrombolytic drugs, and novel endovascu

146 te models showed greater total drainage with alteplase (P <.001), greater patient age (P <.001), larg

147 inition, 1/52 [2%] tenecteplase vs 2/51 [4%] alteplase, p=0.55; by ECASS II definition, 3/52 [6%] vs

148 at 90 days (in 72% of patients, vs. 40% with alteplase; P=0.02).

149 ischemic stroke who were receiving 0.9 mg of alteplase per kilogram of body weight less than 4.5 hour

150 ase plus abciximab (n=143), 7% with 50 mg of alteplase plus abciximab and low-dose heparin (n=103), a

151 rates were significantly higher in the 50-mg alteplase plus abciximab group versus the alteplase-only

152 w-dose heparin (n=103), and 1% with 50 mg of alteplase plus abciximab with very-low-dose heparin (n=7

153 .82-times compared with accelerated infusion alteplase plus parenteral anticoagulants (RR 1.47 [95% C

154 nts; RR 1.26 [1.10-1.45] for non-accelerated alteplase plus parenteral anticoagulants).

155 sation, 453 (47%) of 967 participants in the alteplase plus standard care group and 494 (50%) of 979

156 e included in the analysis (967 [50%] in the alteplase plus standard care group and 979 [50%] in the

157 he first 7 days (99 [10%] of 967 died in the alteplase plus standard care group vs 65 [7%] of 979 in

158 atio to treatment with intravenous 0.9 mg/kg alteplase plus standard care or standard care alone with

159 ete intraventricular haemorrhage removal via alteplase produces gains in functional status.

160 With the dosing regimen used in this study, alteplase produces greater thoracostomy tube output than

161 ith increasing duration of administration of alteplase, progressing from a bolus alone to a bolus fol

162 vascular treatment compared with intravenous alteplase (recombinant tissue plasminogen activator) alo

163 symptom onset, and 24,705 patients received alteplase (recombinant tissue-type plasminogen activator

164 Although no alteplase-related deaths or symptomatic intracranial hae

165 e basis of available trial data, intravenous alteplase remains the initial treatment for all eligible

166 MIS plus alteplase seems to be safe in patients with intracerebra

167 e during the first few days after treatment, alteplase significantly improves the overall odds of a g

168 Alteplase significantly increased the odds of symptomati

169 s received a sufficient volume of the thawed alteplase solution to fill the occluded catheter(s).

170 erine protease tissue plasminogen activator (alteplase, t-PA), and have prolonged half-life features

171 was recorded between accelerated infusion of alteplase, tenecteplase, and reteplase with parenteral a

172 In the Alteplase-Tenecteplase Trial Evaluation for Stroke Throm

173 Greater pleural fluid drainage occurred with alteplase than urokinase during the 1st (P =.001) and 2n

174 Among patients given alteplase, the net outcome is predicted both by time to

175 ublished articles who were given intravenous alteplase, the nine patients in the IPSS cohort were mos

176 platelet characteristics after reteplase and alteplase therapy in the setting of the Global Use of St

177 interval, 0.89-3.51; P=0.102) compared with alteplase therapy.

178 The Alteplase ThromboLysis for Acute Noninterventional Thera

179 intravenous heparin; (3) streptokinase plus alteplase (tissue-type plasminogen activator) with intra

180 These systems are being used to give alteplase to patients with stroke in previously underser

181 nt to plasminogen activator inhibitor-1 than alteplase TPA.

182 ts received a weight-adjusted dose of either alteplase (tPA) (2 to 5 mg/h) or tenecteplase (TNK) (0.5

183 versus 24.3ml (IQR, 16.7-42.2; p = 0.011) in alteplase-treated controls.

184 score of 0 to 1 versus 2 to 6 compared with alteplase-treated patients using linear regression to ge

185 Data from 350 consecutive alteplase-treated patients were analyzed.

186 ility of achieving an excellent outcome with alteplase treatment exceeds the risk of death, early tre

187 s OTT decreased (p=0.0269) and no benefit of alteplase treatment was seen after around 270 min.

188 Alteplase treatment within 6 h after ischaemic stroke wa

189 23 patients with stroke received intravenous alteplase treatment.

190 1 levels within 2 hours after termination of alteplase treatment.

191 o not regain functional independence despite alteplase treatment.

192 ere also reported in patients ineligible for alteplase treatment.

193 ts with target mismatch (33 tenecteplase, 35 alteplase), treatment with tenecteplase was associated w

194 f intracerebral haemorrhage on allocation to alteplase, treatment delay, age, and stroke severity.

195 e and quantitative assessment of barriers to alteplase use and ways to address the findings, and prov

196 , multicomponent intervention could increase alteplase use in community hospitals in Michigan, USA.

197 target-population analysis, the increase in alteplase use in intervention hospitals (59 [1.00%] of 5

198 intervention did not significantly increase alteplase use in patients with ischaemic stroke.

199 The primary outcome was change in alteplase use in patients with stroke in emergency depar

200 for 259 (32.9%) of 787 patients who received alteplase versus 176 (23.1%) of 762 who received control

201 rticipants in the nine trials of intravenous alteplase versus control.

202 (STT) meta-analysis of randomised trials of alteplase versus placebo (or untreated control) in patie

203 to remove intraventricular haemorrhage with alteplase versus saline irrigation improved functional o

204 ing in 231 [6.8%] of 3391 patients allocated alteplase vs 44 [1.3%] of 3365 patients allocated contro

205 but the absolute excess risk attributable to alteplase was bigger among patients who had more severe

206 Alteplase was chosen because its high fibrin affinity ob

207 To make this approach economically feasible, alteplase was diluted to 1 mg/mL and 2.5-mL aliquots wer

208 rease in fatal intracranial haemorrhage from alteplase was similar irrespective of treatment delay, a

209 us recombinant tissue plasminogen activator (alteplase) was approved by the US Food and Drug Administ

210 treptokinase and non-accelerated infusion of alteplase were significantly associated with an increase

211 ither medical therapy (including intravenous alteplase when eligible) and endovascular therapy with t

212 ed to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy

213 cal symptoms and CT benefit from intravenous alteplase when treated up to 4.5 h.

214 oven efficacy for acute ischaemic stroke was alteplase, which is approved for use within 4.5 h after

215 Protocol-based use of alteplase with extraventricular drain seems safe.

216 with intravenous heparin; or (4) accelerated alteplase with intravenous heparin.

217 Compared with accelerated infusion of alteplase with parenteral anticoagulants as background t

218 patients in nine randomised trials comparing alteplase with placebo or open control.

219 e efficacy and safety of tenecteplase versus alteplase within 4.5 h of stroke onset in a population n

220 rsus placebo in stroke patients treated with alteplase within 4.5 hours of onset.

221 ment of middle cerebral artery), intravenous alteplase (yes vs no), baseline Alberta Stroke Program E